Healthcare Provider Details

I. General information

NPI: 1457949919
Provider Name (Legal Business Name): BALANCE POINT ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2021
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 NW GRANT AVE
CORVALLIS OR
97330-4366
US

IV. Provider business mailing address

2005 NW GRANT AVE
CORVALLIS OR
97330-4366
US

V. Phone/Fax

Practice location:
  • Phone: 541-714-3200
  • Fax: 541-638-3275
Mailing address:
  • Phone: 541-714-3200
  • Fax: 541-638-3275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. ONDRIA L HOLUB
Title or Position: OWNER/ACUPUNCTURIST
Credential: BS, MACOM, L.AC
Phone: 541-714-3200