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General NPI Number Information
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NPI Number | 1104449982
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Entity Type | Organization
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Legal Business Name | BALANCED PELVIS LLC
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 1759 W BROADWAY ST STE 1
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City | OVIEDO
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State | FL
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Zip | 32765-8128
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Country | US
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Telephone | 407-734-3318
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Fax |
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Provider Business Mailing Address
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Address Line | 1759 W BROADWAY ST STE 1
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City | OVIEDO
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State | FL
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Zip | 32765-8128
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MELISSA SCHUBERT
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Credential | PHYSICAL THERAPIST
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Telephone | 407-760-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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