Healthcare Provider Details

I. General information

NPI: 1831709500
Provider Name (Legal Business Name): THE BALANCE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 11/12/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 OLD MEADOW RD
MC LEAN VA
22102-4331
US

IV. Provider business mailing address

4002 MILLCREEK DR
ANNANDALE VA
22003-2334
US

V. Phone/Fax

Practice location:
  • Phone: 703-403-0848
  • Fax:
Mailing address:
  • Phone: 703-403-0848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TERESITA DEAL
Title or Position: OWNER/PT
Credential: PT
Phone: 703-403-0848