Healthcare Provider Details
I. General information
NPI: 1013761584
Provider Name (Legal Business Name): LIFE IN BALANCE OSTEOPATHIC MEDICAL CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/12/2024
Last Update Date: 09/02/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2565 S ROCHESTER RD STE 108B
ROCHESTER HILLS MI
48307-4472
US
IV. Provider business mailing address
2565 S ROCHESTER RD STE 108B
ROCHESTER HILLS MI
48307-4472
US
V. Phone/Fax
- Phone: 586-465-2308
- Fax: 586-261-5452
- Phone: 586-465-2308
- Fax: 586-261-5452
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMBER
MARIE
GRUBER
Title or Position: OWNER/PHYSICIAN
Credential: DO
Phone: 586-465-2308