Healthcare Provider Details

I. General information

NPI: 1306701677
Provider Name (Legal Business Name): BALANCED BODY ACUPUNCTURE & AESTHETICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 STILESBORO RD NW STE 400
KENNESAW GA
30152-7759
US

IV. Provider business mailing address

5150 STILESBORO RD NW STE 400
KENNESAW GA
30152-7759
US

V. Phone/Fax

Practice location:
  • Phone: 770-430-5030
  • Fax:
Mailing address:
  • Phone: 770-430-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MRS. TAMERA FIRNBACH
Title or Position: OWNER
Credential: L.AC
Phone: 770-430-5030