Individual
MICHAEL JOHN BALFANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
WLMT
Contact information
Practice address
2585 DOOR CREEK RD, STOUGHTON, WI 53589-2842
(608) 712-2775
Mailing address
2585 DOOR CREEK RD, STOUGHTON, WI 53589-2842
(608) 712-2775
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
146-11537
WI
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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