Healthcare Provider Details

I. General information

NPI: 1053045831
Provider Name (Legal Business Name): BALANCE NATUROPATHIC & ACUPUNCTURE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2022
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 BRAWLEY SCHOOL RD STE E
MOORESVILLE NC
28117-9283
US

IV. Provider business mailing address

736 BRAWLEY SCHOOL RD STE E
MOORESVILLE NC
28117-9283
US

V. Phone/Fax

Practice location:
  • Phone: 704-664-1031
  • Fax: 704-664-1035
Mailing address:
  • Phone: 704-664-1031
  • Fax: 704-664-1035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: DR. MENG XIONG
Title or Position: DOCTOR
Credential: ND, LAC
Phone: 253-993-0931