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General NPI Number Information
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NPI Number | 1225635386
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Entity Type | Organization
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Legal Business Name | BALANCENTER WELLNESS INC
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 210 MAIN ST FL 2
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City | HALF MOON BAY
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State | CA
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Zip | 94019-1722
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Country | US
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Telephone | 650-333-1433
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Fax |
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Provider Business Mailing Address
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Address Line | 3225 MCLEOD DR STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89121-2257
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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 | OPERATIONS MANAGER
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Name | SUSAN MOLINA
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Credential |
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Telephone | 949-836-7698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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