Organization Name: | BODY BALANCE GOLF & PHYSICAL THERAPY, LLC |
NPI Number: | 1023014859 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID JOHN WIEBER (OWNER) |
Mailing Address: | 2070 W 96th St Bloomington |
State: | MN US |
Postal Code: | 554312517 |
Phone Number: | 9528889549 |
Fax Number: | 9527033481 |
NPI Enumeration Date: | 06/27/2005 |
NPI Last Update Date: | 02/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |