=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346223930
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PERFECT BALANCE PHYSICAL THERAPY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2005
-----------------------------------------------------
Last Update Date | 08/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4 S TUNNEL RD STE 440
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28805-2582
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-785-4700
-----------------------------------------------------
Fax | 828-552-5566
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 632663
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45263-2663
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-268-7213
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF CLINICAL OFFICER
-----------------------------------------------------
Name | ERIC ELDON DOUGLASS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 941-870-4401
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------