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General NPI Number Information
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NPI Number | 1558542605
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Entity Type | Organization
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Legal Business Name | BALANCED BODY SERVICES
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 383 SHOESMITH RD
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City | HASLETT
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State | MI
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Zip | 48840-9790
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Country | US
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Telephone | 517-339-7617
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Fax |
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Provider Business Mailing Address
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Address Line | 383 SHOESMITH RD
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City | HASLETT
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State | MI
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Zip | 48840-9790
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Country | US
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Telephone | 517-339-7617
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JON ROBERT CHESTER
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Credential | PT
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Telephone | 517-339-7617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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