Organization
BALANCE IN LIFE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THADDEUS P. SRUTWA M.D. (OWNER)
(616) 229-3295
Entity
Organization
Contact information
Practice address
16986 ROBBINS RD STE 180, GRAND HAVEN, MI 49417-2795
(616) 229-3295
(616) 229-3295
Mailing address
16986 ROBBINS RD STE 180, GRAND HAVEN, MI 49417-2795
(616) 229-3295
(616) 229-3295
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301045363
MI
208VP0000X
Pain Medicine Physician
4301045363
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080G014920
BCBS
MI
Enumeration date
04/01/2009
Last updated
07/08/2019
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