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General NPI Number Information
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NPI Number | 1023027828
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Entity Type | Organization
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Legal Business Name | BALANCE WELLNESS AND CHIROPRACTIC CENTER P.C.
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 415 W ROCKRIMMON BLVD STE 400
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-1773
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Country | US
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Telephone | 719-265-0115
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Fax | 719-265-0116
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Provider Business Mailing Address
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Address Line | 415 W ROCKRIMMON BLVD STE 400
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-1773
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Country | US
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Telephone | 719-265-0115
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Fax | 719-265-0116
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | SCOTT M. GAMM
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Credential | D.C.
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Telephone | 719-265-0115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6466
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License Number State | CO
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