Healthcare Provider Details

I. General information

NPI: 1689438749
Provider Name (Legal Business Name): A JUST BALANCE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2024
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 FARMHOUSE RD
CAMPOBELLO SC
29322-9344
US

IV. Provider business mailing address

3740 BOILING SPRINGS RD # 127
BOILING SPRINGS SC
29316-5716
US

V. Phone/Fax

Practice location:
  • Phone: 864-702-8090
  • Fax:
Mailing address:
  • Phone: 864-702-8090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LESLIE ALLISON SHIELDS
Title or Position: OWNER
Credential: DPT
Phone: 864-702-8090