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General NPI Number Information
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NPI Number | 1730407289
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Entity Type | Organization
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Legal Business Name | BIO BALANCE THERAPY, LLC
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Dates
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Enumeration Date | 05/07/2010
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 23023 ORCHARD LAKE RD STE C
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-3267
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Country | US
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Telephone | 248-354-3117
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Fax |
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Provider Business Mailing Address
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Address Line | 22521 GLENMOOR HTS
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City | FARMINGTON HILLS
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State | MI
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Zip | 48336-3523
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Country | US
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Telephone | 248-345-3117
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAMELIA EUGENIA TAMASANU
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Credential |
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Telephone | 248-345-3117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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