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General NPI Number Information
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NPI Number | 1497146336
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Entity Type | Organization
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Legal Business Name | REBALANCE BIOHEALTH LLC
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Dates
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Enumeration Date | 02/13/2015
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 8400 E CRESCENT PKWY SUITE 600
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2831
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Country | US
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Telephone | 817-791-2775
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Fax |
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Provider Business Mailing Address
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Address Line | 8400 E CRESCENT PKWY SUITE 600
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2831
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Country | US
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Telephone | 817-791-2775
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Fax |
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Authorized Official
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Title or Position | EVP NEW BUSINESS INITIATIVES
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Name | MR. DON C PURDY
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Credential |
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Telephone | 817-791-2775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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