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General NPI Number Information
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NPI Number | 1831911551
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Entity Type | Organization
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Legal Business Name | BALANCED PHYSICAL THERAPY MIDLAND PLLC
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 810 E ASHMAN ST
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City | MIDLAND
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State | MI
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Zip | 48642-4505
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Country | US
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Telephone | 989-486-1232
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Fax |
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Provider Business Mailing Address
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Address Line | 810 E ASHMAN ST
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City | MIDLAND
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State | MI
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Zip | 48642-4505
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Country | US
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Telephone | 989-486-1232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH OMALLEY
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Credential |
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Telephone | 989-486-1232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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