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General NPI Number Information
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NPI Number | 1609929058
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Entity Type | Organization
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Legal Business Name | INBALANCE, A WOMEN'S HEALTH & WELLNESS CENTER, INC.
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 31105 RANCHO VIEJO RD SUITE C5
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-1717
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Country | US
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Telephone | 949-218-4141
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Fax | 949-218-4242
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Provider Business Mailing Address
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Address Line | 31105 RANCHO VIEJO RD SUITE C5
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-1717
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Country | US
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Telephone | 949-218-4141
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Fax | 949-218-4242
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | HAYLEY SUE SEDELL
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Credential | MPT
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Telephone | 949-218-4141
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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 | PT21120
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License Number State | CA
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