Provider Demographics
NPI:1831193309
Name:BALENGER, DAVID BRANDON (DPT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BRANDON
Last Name:BALENGER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 BILL ROBISON PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36206-2610
Mailing Address - Country:US
Mailing Address - Phone:256-820-8555
Mailing Address - Fax:256-820-8554
Practice Address - Street 1:100 BILL ROBISON PKWY STE C
Practice Address - Street 2:CENTRAL PARK
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36206-2610
Practice Address - Country:US
Practice Address - Phone:256-820-8555
Practice Address - Fax:256-820-8554
Is Sole Proprietor?:No
Enumeration Date:2005-06-11
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4175225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102G705459Medicare UPIN