Healthcare Provider Details
I. General information
NPI: 1720664006
Provider Name (Legal Business Name): BALANCE CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/18/2021
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5801 KENNETT PIKE STE AB
WILMINGTON DE
19807-1123
US
IV. Provider business mailing address
5801 KENNETT PIKE STE AB
WILMINGTON DE
19807-1123
US
V. Phone/Fax
- Phone: 302-545-2640
- Fax:
- Phone: 302-545-2640
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NN0400X |
| Taxonomy | Neurology Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TOBI
REID
SHEIKER
Title or Position: PRESIDENT
Credential: DC
Phone: 302-545-1640