Healthcare Provider Details

I. General information

NPI: 1336711498
Provider Name (Legal Business Name): RETURN TO BALANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20369 MACK AVE
GROSSE POINTE WOODS MI
48236-1610
US

IV. Provider business mailing address

500 SADDLE LN
GROSSE POINTE WOODS MI
48236-2729
US

V. Phone/Fax

Practice location:
  • Phone: 313-410-1879
  • Fax:
Mailing address:
  • Phone: 313-410-1879
  • 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. LORA TOD
Title or Position: PRESIDENT
Credential: L.AC.
Phone: 313-498-7537