Healthcare Provider Details

I. General information

NPI: 1841342052
Provider Name (Legal Business Name): INNOVATIVE BALANCE & THERAPY CLINICS,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10830 STACEY LN
BOCA RATON FL
33428-4049
US

IV. Provider business mailing address

10830 STACEY LN
BOCA RATON FL
33428-4049
US

V. Phone/Fax

Practice location:
  • Phone: 561-703-7884
  • Fax: 561-218-0388
Mailing address:
  • Phone: 561-218-3729
  • Fax: 561-218-0388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. GWENDOLYN JEAN BOYD
Title or Position: PRESIDENT
Credential: PT
Phone: 561-207-0989