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General NPI Number Information
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NPI Number | 1750159596
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Entity Type | Organization
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Legal Business Name | A BALANCED APPROACH TO WELLNESS PLLC
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 1210 TOWANDA AVE STE 13
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City | BLOOMINGTON
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State | IL
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Zip | 61701-7415
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Country | US
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Telephone | 309-310-2619
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Fax |
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Provider Business Mailing Address
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Address Line | 3 STORTZ DR APT A2
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City | BLOOMINGTON
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State | IL
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Zip | 61701-2072
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Country | US
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Telephone | 309-310-2619
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAVANNAH R SWANLUND
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Credential | LMT, PTA
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Telephone | 309-310-2619
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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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