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General NPI Number Information
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NPI Number | 1881342475
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Entity Type | Organization
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Legal Business Name | BALANCE THE ENERGY LLC
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Dates
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Enumeration Date | 03/14/2022
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 2626 VIENNA CT
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City | GREEN BAY
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State | WI
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Zip | 54302-4945
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Country | US
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Telephone | 920-530-9636
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Fax |
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Provider Business Mailing Address
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Address Line | 2626 VIENNA CT
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City | GREEN BAY
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State | WI
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Zip | 54302-4945
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/OWNER
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Name | ALIZA HELEN BUYARSKI
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Credential | OTR
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Telephone | 920-530-9636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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