Provider Demographics
NPI:1821242405
Name:BILANCIA INC
Entity Type:Organization
Organization Name:BILANCIA INC
Other - Org Name:BALANCE WORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDORTHIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:GOODSPEED
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:802-773-1543
Mailing Address - Street 1:106 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-4542
Mailing Address - Country:US
Mailing Address - Phone:802-773-1543
Mailing Address - Fax:802-776-4116
Practice Address - Street 1:106 ALLEN ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4542
Practice Address - Country:US
Practice Address - Phone:802-773-1543
Practice Address - Fax:802-776-4116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1006112Medicaid
VT1006112Medicaid