Healthcare Provider Details

I. General information

NPI: 1821524562
Provider Name (Legal Business Name): INNER BALANCE PELVIC HEALTH AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2299 WOODBURY AVE SUITE 1
NEWINGTON NH
03801
US

IV. Provider business mailing address

2299 WOODBURY AVE SUITE 1
NEWINGTON NH
03801
US

V. Phone/Fax

Practice location:
  • Phone: 603-230-2433
  • Fax: 603-658-0938
Mailing address:
  • Phone: 603-230-2433
  • Fax: 603-658-0938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number11949
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11949
License Number StateNH

VIII. Authorized Official

Name: DR. COLENE COLENE ARNOLD
Title or Position: PHYSICIAN
Credential: MD
Phone: 603-230-2433