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General NPI Number Information
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NPI Number | 1588192702
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Entity Type | Organization
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Legal Business Name | CORE BALANCE PLC
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Dates
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Enumeration Date | 06/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2026 PARKVIEW AVE
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City | KALAMAZOO
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State | MI
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Zip | 49008-2834
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Country | US
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Telephone | 269-352-6045
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Fax |
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Provider Business Mailing Address
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Address Line | 6825 BENTLEY DR
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City | KALAMAZOO
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State | MI
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Zip | 49009-5916
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Country | US
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Telephone | 269-352-6045
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. BARBARA A EBY
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Credential | PT, DPT, MED
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Telephone | 269-352-6045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | MI
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