Provider Demographics
NPI:1760791974
Name:BALINAS, EUZAR
Entity Type:Individual
Prefix:MR
First Name:EUZAR
Middle Name:
Last Name:BALINAS
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:EUZAR
Other - Middle Name:
Other - Last Name:BALINAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:914 MAIN ST W APT 7
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-1362
Mailing Address - Country:US
Mailing Address - Phone:608-576-9779
Mailing Address - Fax:
Practice Address - Street 1:1319 BEASER AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-3614
Practice Address - Country:US
Practice Address - Phone:715-682-3468
Practice Address - Fax:715-682-8872
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2013-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11319-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist