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General NPI Number Information
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NPI Number | 1770037962
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Entity Type | Organization
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Legal Business Name | BALANCED HEALTH CARE
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Dates
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Enumeration Date | 08/05/2016
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Last Update Date | 08/05/2016
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Provider Practice Location Address
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Address Line | 169 W 2710 SOUTH CIR STE 204
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City | ST GEORGE
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State | UT
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Zip | 84790-7201
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Country | US
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Telephone | 435-688-2292
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Fax | 435-688-2675
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Provider Business Mailing Address
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Address Line | 169 W 2710 SOUTH CIR STE 204
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City | ST GEORGE
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State | UT
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Zip | 84790-7201
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Country | US
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Telephone | 435-688-2292
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Fax | 435-688-2675
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Authorized Official
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Title or Position | CEO
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Name | DR. BRENT NOORDA
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Credential | D.C.
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Telephone | 435-688-2292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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