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General NPI Number Information
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NPI Number | 1508183039
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Entity Type | Organization
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Legal Business Name | BALANCED BODY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 96 E BREMER AVE
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City | WAVERLY
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State | IA
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Zip | 50677-3316
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Country | US
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Telephone | 319-352-1222
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Fax | 319-352-1222
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Provider Business Mailing Address
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Address Line | 96 E BREMER AVE
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City | WAVERLY
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State | IA
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Zip | 50677-3316
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Country | US
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Telephone | 319-352-1222
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Fax | 319-352-1222
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. HEATHER LYNN GEHLING
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Credential | D.C.
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Telephone | 319-352-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 007157
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License Number State | IA
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