Provider Demographics
NPI:1083488670
Name:BALANCE FOOT & ANKLE PLLC
Entity type:Organization
Organization Name:BALANCE FOOT & ANKLE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOMASZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BIERNACKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:734-635-7104
Mailing Address - Street 1:4055 HIDDEN TRL
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-5200
Mailing Address - Country:US
Mailing Address - Phone:810-206-1402
Mailing Address - Fax:248-707-2827
Practice Address - Street 1:4330 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8582
Practice Address - Country:US
Practice Address - Phone:810-206-1402
Practice Address - Fax:833-450-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Multi-Specialty