Healthcare Provider Details

I. General information

NPI: 1891240933
Provider Name (Legal Business Name): BALANCE REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 08/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 HAYES MILL RD
ATCO NJ
08004-2457
US

IV. Provider business mailing address

114 HAYES MILL RD
ATCO NJ
08004-2457
US

V. Phone/Fax

Practice location:
  • Phone: 856-809-7242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LAURIE SENTMAN
Title or Position: SENIOR VICE PRESIDENT
Credential: PTA
Phone: 609-685-1964