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General NPI Number Information
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NPI Number | 1013761584
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Entity Type | Organization
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Legal Business Name | LIFE IN BALANCE OSTEOPATHIC MEDICAL CENTER PLLC
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Dates
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Enumeration Date | 04/12/2024
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2565 S ROCHESTER RD STE 108B
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-4472
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Country | US
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Telephone | 586-465-2308
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Fax | 586-261-5452
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Provider Business Mailing Address
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Address Line | 2565 S ROCHESTER RD STE 108B
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-4472
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Country | US
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Telephone | 586-465-2308
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Fax | 586-261-5452
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | AMBER MARIE GRUBER
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Credential | DO
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Telephone | 586-465-2308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number |
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License Number State |
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