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General NPI Number Information
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NPI Number | 1649975681
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Entity Type | Organization
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Legal Business Name | BALANCE TMS, ESKETAMINE, AND PSYCHIATRY PLLC
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Dates
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Enumeration Date | 03/31/2023
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 1517 N ANKENY BLVD STE E
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City | ANKENY
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State | IA
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Zip | 50023-4120
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Country | US
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Telephone | 814-720-5669
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Fax |
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Provider Business Mailing Address
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Address Line | 1517 N ANKENY BLVD STE E
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City | ANKENY
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State | IA
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Zip | 50023-4120
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Country | US
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Telephone | 814-720-5669
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AHMAR BUTT
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Credential | MD
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Telephone | 814-720-5669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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