Individual
MARK ERWIN BALBANIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3450 QUAIL LAKE RD APT 161, COLORADO SPRINGS, CO 80906-4680
(347) 707-5583
Mailing address
3450 QUAIL LAKE RD APT 161, COLORADO SPRINGS, CO 80906-4680
(347) 707-5583
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.0000789
CO
Other
Enumeration date
08/25/2017
Last updated
07/21/2022
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