Healthcare Provider Details

I. General information

NPI: 1417277286
Provider Name (Legal Business Name): BODY IN BALANCE CHIROPRACTIC AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 02/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 E MILL PLAIN BLVD
VANCOUVER WA
98664-2010
US

IV. Provider business mailing address

8501 E MILL PLAIN BLVD
VANCOUVER WA
98664-2010
US

V. Phone/Fax

Practice location:
  • Phone: 360-718-2346
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY BRAHMER
Title or Position: OFFICE MANAGER
Credential:
Phone: 360-718-2346