Individual provider Active NPI

Justin Bal, DPT

  • Physical Therapist
  • Antigo, WI
National Provider Identifier
1003761198
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17590-24 Issued in WI
Practice address
112 E 5TH Ave
Antigo, WI 54409-2710
Phone
(715) 623-2331
NPI assigned
Mar 3, 2026
Last updated
Mar 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501303858 MI
Physical Therapist 225100000X 17590-24 WI Primary

Addresses

Primary practice location

112 E 5TH Ave
Antigo, WI 54409-2710

Mailing address

W5950 Springview Dr
Norway, MI 49870-2282
Phone (906) 282-5437

Other practice location 1

2030 Black River St Ste 4
Deckerville, MI 48427-9440
Phone (810) 376-3400

Other practice location 2

800 W Lawrence Ave
Charlotte, MI 48813-1308
Phone (517) 541-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5501303858MIMDPhysical Therapist
17590-24WIMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1772496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1003761198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5950 SPRINGVIEW DR",
            "city": "NORWAY",
            "state": "MI",
            "postal_code": "498702282",
            "telephone_number": "906-282-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-2331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2030 Black River St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Deckerville",
            "state": "MI",
            "postal_code": "484279440",
            "country_code": "US",
            "telephone_number": "810-376-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 W Lawrence Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "MI",
            "postal_code": "488131308",
            "country_code": "US",
            "telephone_number": "517-541-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAL",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-03",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303858",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "17590-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antigo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.