Organization Name: | BALANCE THERAPEUTIC MASSAGE AND CORE FITNESS STUDIO, LLC |
NPI Number: | 1306086350 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LISA ANN BOURLON (OWNER) |
Mailing Address: | 238 Se 2nd Ave Hillsboro |
State: | OR US |
Postal Code: | 971234017 |
Phone Number: | 5033583385 |
Fax Number: | |
NPI Enumeration Date: | 03/04/2009 |
NPI Last Update Date: | 03/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 14779 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |