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General NPI Number Information
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NPI Number | 1942336987
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Entity Type | Organization
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Legal Business Name | BALANCED HEALTH CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 52B EAST MAIN STREET
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City | ZEELAND
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State | MI
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Zip | 49464-1770
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Country | US
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Telephone | 616-772-9255
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Fax | 616-772-9258
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Provider Business Mailing Address
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Address Line | 300 S STATE ST SUITE 4
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City | ZEELAND
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State | MI
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Zip | 49464-1676
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Country | US
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Telephone | 616-772-9255
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Fax | 616-772-9258
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Authorized Official
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Title or Position | PRESIDENT
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Name | STANLEY ALLEN DOMBROSKI
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Credential | DC
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Telephone | 616-772-9255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | SD008737
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License Number State | MI
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