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General NPI Number Information
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NPI Number | 1144625401
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Entity Type | Organization
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Legal Business Name | BALANCED HEALTH PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/29/2014
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Last Update Date | 02/06/2015
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Provider Practice Location Address
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Address Line | 41 ARTERIAL PLZ
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-2512
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Country | US
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Telephone | 518-775-9554
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Fax | 518-773-7747
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Provider Business Mailing Address
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Address Line | 41 ARTERIAL PLZ
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-2512
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Country | US
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Telephone | 518-775-9554
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Fax | 518-773-7747
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | NANCY E MCCORMICK
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Credential | PT
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Telephone | 518-775-9554
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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 | 011442-1
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License Number State | NY
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