Provider Demographics
NPI:1043387442
Name:BODY IN BALANCE CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:BODY IN BALANCE CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-215-0390
Mailing Address - Street 1:710 GOLDEN RIDGE RD STE 114
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9566
Mailing Address - Country:US
Mailing Address - Phone:303-215-0390
Mailing Address - Fax:303-215-0392
Practice Address - Street 1:710 GOLDEN RIDGE RD STE 114
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-9566
Practice Address - Country:US
Practice Address - Phone:303-215-0390
Practice Address - Fax:303-215-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5707111N00000X
CO5708111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO802629Medicare PIN
CO802631Medicare PIN
CO802630Medicare PIN