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General NPI Number Information
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NPI Number | 1942316591
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Entity Type | Organization
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Legal Business Name | BALA SPINE & WELLNESS
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 25 BALA AVE SUITE 202
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City | BALA CYNWYD
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State | PA
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Zip | 19004-3213
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Country | US
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Telephone | 610-668-6862
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Fax |
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Provider Business Mailing Address
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Address Line | 25 BALA AVE SUITE 202
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City | BALA CYNWYD
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State | PA
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Zip | 19004-3213
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Country | US
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Telephone | 610-668-6862
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | ROBERT LITMAN
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Credential |
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Telephone | 610-668-6862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OS003034L
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License Number State | PA
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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 | DC007842L
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License Number State | PA
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