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General NPI Number Information
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NPI Number | 1457049231
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Entity Type | Organization
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Legal Business Name | IN BALANCE PHYSICAL THERAPY
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Dates
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Enumeration Date | 04/28/2023
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 84 THEATRE DR STE 500
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-3131
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Country | US
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Telephone | 904-770-2552
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Fax |
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Provider Business Mailing Address
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Address Line | 84 THEATRE DR STE 500
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-3131
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Country | US
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Telephone | 904-770-2552
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOSEPH R VERNA
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Credential | DC
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Telephone | 484-459-0780
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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 |
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License Number State |
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