Provider Demographics
NPI:1407030117
Name:BALOY, RODIEL KIRBY LAYSON II (MS, PT, CSCS)
Entity Type:Individual
Prefix:MR
First Name:RODIEL KIRBY
Middle Name:LAYSON
Last Name:BALOY
Suffix:II
Gender:M
Credentials:MS, PT, CSCS
Other - Prefix:
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Mailing Address - Street 1:8873 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-3301
Mailing Address - Country:US
Mailing Address - Phone:714-600-1758
Mailing Address - Fax:714-962-8819
Practice Address - Street 1:8873 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-3301
Practice Address - Country:US
Practice Address - Phone:714-962-8818
Practice Address - Fax:714-962-8819
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT34304225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist