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General NPI Number Information
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NPI Number | 1477457638
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Entity Type | Organization
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Legal Business Name | BALANCED PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 3930 GLADE RD STE 124
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City | COLLEYVILLE
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State | TX
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Zip | 76034-5932
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Country | US
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Telephone | 817-886-3783
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Fax | 817-438-7776
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Provider Business Mailing Address
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Address Line | 3930 GLADE RD STE 124
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City | COLLEYVILLE
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State | TX
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Zip | 76034-5932
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Country | US
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Telephone | 817-886-3783
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Fax | 817-438-7776
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Authorized Official
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Title or Position | MANAGER
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Name | MR. TWITCH CHADWICK BRACKEN
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Credential |
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Telephone | 817-385-9316
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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 | NULL
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