Provider Demographics
NPI:1568755171
Name:BALZER, HEATHER ANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:ANNE
Last Name:BALZER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CHESANING
Mailing Address - State:MI
Mailing Address - Zip Code:48616-1203
Mailing Address - Country:US
Mailing Address - Phone:989-845-3609
Mailing Address - Fax:989-845-3121
Practice Address - Street 1:126 W BROAD ST
Practice Address - Street 2:
Practice Address - City:CHESANING
Practice Address - State:MI
Practice Address - Zip Code:48616-1203
Practice Address - Country:US
Practice Address - Phone:989-845-3609
Practice Address - Fax:989-845-3121
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302036421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist