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General NPI Number Information
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NPI Number | 1003426297
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Entity Type | Organization
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Legal Business Name | BAL THERAPY LLC
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 4019 18TH ST S
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City | ARLINGTON
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State | VA
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Zip | 22204-5141
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Country | US
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Telephone | 703-967-9981
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Fax | 571-464-6587
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Provider Business Mailing Address
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Address Line | 4019 18TH ST S
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City | ARLINGTON
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State | VA
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Zip | 22204-5141
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Country | US
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Telephone | 703-967-9981
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JACK EDWARD BAL JR.
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Credential | PT, DPT
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Telephone | 703-967-9981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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