Individual
KRISTINE MARIE BALAVITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
15050 E JEFFERSON AVE, GROSSE POINTE PARK, MI 48230-2050
(248) 938-0141
Mailing address
41424 ANN ARBOR RD E, PLYMOUTH, MI 48170-8005
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601009978
MI
Other
Enumeration date
07/17/2020
Last updated
09/01/2022
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