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General NPI Number Information
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NPI Number | 1700737244
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Entity Type | Organization
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Legal Business Name | INNERBALANCE DIAGNOSIS CENTER
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Dates
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Enumeration Date | 02/09/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 4275 JOHNS CREEK PKWY STE B
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City | JOHNS CREEK
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State | GA
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Zip | 30024-9117
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Country | US
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Telephone | 919-576-2607
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Fax | 919-935-0858
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Provider Business Mailing Address
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Address Line | 501 W WILLIAMS ST UNIT 1036
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City | APEX
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State | NC
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Zip | 27502-2297
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Country | US
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Telephone | 919-576-2607
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Fax | 919-935-0858
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. SHIRLEYJO B LEE
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Credential |
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Telephone | 919-576-2607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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