Provider Demographics
NPI:1275385478
Name:BALSLEY-HARGETT, GEORGIA LYNN (ND)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:LYNN
Last Name:BALSLEY-HARGETT
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W MICHIGAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1586
Mailing Address - Country:US
Mailing Address - Phone:269-268-0410
Mailing Address - Fax:
Practice Address - Street 1:105 W MICHIGAN AVE STE B
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1586
Practice Address - Country:US
Practice Address - Phone:269-268-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath