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General NPI Number Information
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NPI Number | 1124209119
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Entity Type | Organization
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Legal Business Name | BALANCED REHAB LLC
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Dates
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Enumeration Date | 11/18/2007
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 160 S BEACH ST
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4408
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Country | US
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Telephone | 386-252-2400
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Fax | 386-252-2414
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Provider Business Mailing Address
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Address Line | 160 S BEACH ST
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4408
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Country | US
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Telephone | 386-252-2400
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MR. ANTONIOS ARNAOUTIS
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Credential | P.T.
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Telephone | 386-252-2400
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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 | PT13031
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License Number State | FL
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