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General NPI Number Information
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NPI Number | 1225245749
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Entity Type | Organization
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Legal Business Name | BALANCED PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 12940 W CAMPBELL AVE
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-5184
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Country | US
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Telephone | 602-432-2567
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Fax |
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Provider Business Mailing Address
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Address Line | 12940 W CAMPBELL AVE
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-5184
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Country | US
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Telephone | 602-432-2567
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Fax |
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Authorized Official
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Title or Position | CEO PHYSICAL THERAPIST
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Name | HEATHER ELIZABETH CHOWANIEC
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Credential | PT
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Telephone | 602-432-2567
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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 | 5529
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License Number State | AZ
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