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NPI Code Detail

MEDICARE: LIFE BALANCE PHYSICAL THERAPY & WELLNESS

MEDICARE: LIFE BALANCE PHYSICAL THERAPY & WELLNESS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1134354285
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE BALANCE PHYSICAL THERAPY & WELLNESS
Provider Business Mailing Address
First Line : 6419 OUTER BRIDGE LN
Second Line :
City : CHARLOTTE
State : NC
Zip : 28270-1730
Country : US
Telephone Number : 202-255-7409
Fax Number :
Provider Business Practice Location Address
First Line : 190 HENDERSONVILLE RD STE 95
Second Line :
City : ASHEVILLE
State : NC
Zip : 28803-2680
Country : US
Telephone Number : 202-255-7409
Fax Number :
Authorized Official
Title or Position : PHYSICAL THERAPIST/ OWNER
Name : GRACE LEUNG STOCKDALE
Credential : MSPT
Telephone Number : 202-255-7409
Provider Enumeration Date : 05/19/2009
Last Update Date : 10/13/2024

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Directions to “LIFE BALANCE PHYSICAL THERAPY & WELLNESS ” Practice Location

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