Healthcare Provider Details

I. General information

NPI: 1447404058
Provider Name (Legal Business Name): M A BALANCE INSTITUTE OF JOHNSON COUNTY KANSAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2008
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7207 W 110TH ST
OVERLAND PARK KS
66210-2339
US

IV. Provider business mailing address

7207 W 110TH ST
OVERLAND PARK KS
66210-2339
US

V. Phone/Fax

Practice location:
  • Phone: 816-246-1456
  • Fax: 816-286-2774
Mailing address:
  • Phone: 816-246-1456
  • Fax: 816-286-2774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. GERALD N LAMPE
Title or Position: PRESIDENT
Credential: PT PHD
Phone: 913-221-1148