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General NPI Number Information
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NPI Number | 1073732608
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Entity Type | Organization
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Legal Business Name | BALANCE ATLANTA, INC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 360 PHARR RD, LOWEL LEVEL 101, SUITE C
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City | ATLANTA
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State | GA
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Zip | 30305-2350
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Country | US
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Telephone | 404-261-4848
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Fax | 404-261-4846
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Provider Business Mailing Address
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Address Line | PO BOX 550369
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City | ATLANTA
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State | GA
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Zip | 30355-2869
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Country | US
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Telephone | 404-261-4848
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Fax | 404-261-4846
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CAROLINE VON FLUEGGE
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Credential | DC
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Telephone | 404-261-4848
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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 | GA 6128
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License Number State | GA
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