Healthcare Provider Details

I. General information

NPI: 1568066249
Provider Name (Legal Business Name): THE HORMONE BALANCE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2020
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12425 OLD MERIDIAN ST STE B3
CARMEL IN
46032-8725
US

IV. Provider business mailing address

6029 CHICKNEY DR
NOBLESVILLE IN
46062-5526
US

V. Phone/Fax

Practice location:
  • Phone: 317-796-8800
  • Fax: 844-770-0404
Mailing address:
  • Phone: 317-965-6515
  • Fax: 844-770-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROGER G SPAHR
Title or Position: OWNER
Credential: MD
Phone: 317-796-8800