Basic Information
| Provider Information | |||||||||
| NPI: | 1326152802 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BALANCE SOLUTIONS PHYSICAL THERAPY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23175 COMMERCE PARK | ||||||||
| Address2: | |||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441225806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4404493400 | ||||||||
| FaxNumber: | 4404493402 | ||||||||
| Practice Location | |||||||||
| Address1: | 23175 COMMERCE PARK | ||||||||
| Address2: | |||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441225806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4404493400 | ||||||||
| FaxNumber: | 4404493402 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2006 | ||||||||
| LastUpdateDate: | 04/19/2019 | ||||||||
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| AuthorizedOfficialLastName: | BEAUDOIN | ||||||||
| AuthorizedOfficialFirstName: | KELLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4404493400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | MSPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.