Organization Name: | BALANCED BODIES LLC |
NPI Number: | 1285944199 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MEEJUNG JANE PARK (OWNER) |
Mailing Address: | 2001 Midwest Road Suite 302 Oakbrook |
State: | IL US |
Postal Code: | 605231343 |
Phone Number: | 6302790032 |
Fax Number: | 6302791833 |
NPI Enumeration Date: | 10/13/2010 |
NPI Last Update Date: | 10/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 070010605 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |