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Individual

ETHAN BALOGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
3509 S NOLAND RD, INDEPENDENCE, MO 64055-3339
(816) 313-2220
(816) 897-2390
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-6200

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2026006907
MO
225100000X
Physical Therapist
Primary
MO

Other

Enumeration date
12/23/2025
Last updated
02/12/2026
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