Healthcare Provider Details
I. General information
NPI: 1609595057
Provider Name (Legal Business Name): BALANCE AND CONCUSSION THERAPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2022
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2 UNIVERSITY PLAZA DRIVE SUITE 100
HACKENSACK NJ
07601
US
IV. Provider business mailing address
440 SAGAMORE AVE
TEANECK NJ
07666-2626
US
V. Phone/Fax
- Phone: 551-888-2282
- Fax:
- Phone: 551-888-2282
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251N0400X |
| Taxonomy | Neurology Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIT
MACKLIN
Title or Position: OWNER/DIRECTOR
Credential: PT, DPT
Phone: 551-888-2282