Provider Demographics
NPI:1245655083
Name:BALALE, AMELIA (PT, MS)
Entity type:Individual
Prefix:MS
First Name:AMELIA
Middle Name:
Last Name:BALALE
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6451 CENTER ST.
Mailing Address - Street 2:MENTOR PUBLIC SCHOOLS
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060
Mailing Address - Country:US
Mailing Address - Phone:440-255-4444
Mailing Address - Fax:440-255-4622
Practice Address - Street 1:7860 JOHNNYCAKE RIDGE RD
Practice Address - Street 2:RIDGE MIDDLE SCHOOL
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060
Practice Address - Country:US
Practice Address - Phone:440-974-5409
Practice Address - Fax:440-974-5285
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH18672251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics