Healthcare Provider Details

I. General information

NPI: 1841986551
Provider Name (Legal Business Name): BALANCE FOR LIFE CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 04/14/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 EASTSIDE CENTRE CT STE 2
MOUNTAIN HOME AR
72653-2748
US

IV. Provider business mailing address

1310 EASTSIDE CENTRE CT STE 2
MOUNTAIN HOME AR
72653-2748
US

V. Phone/Fax

Practice location:
  • Phone: 870-736-6229
  • Fax:
Mailing address:
  • Phone: 870-736-6229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIKA BETH ECKMAN
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: DC
Phone: 870-736-6229