Provider Demographics
NPI:1063656940
Name:COUNTERBALANCE INCORPORATED
Entity Type:Organization
Organization Name:COUNTERBALANCE INCORPORATED
Other - Org Name:THE THERAPY PLACE AT SURREY HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:EASTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-373-3122
Mailing Address - Street 1:11216 NW EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-8373
Mailing Address - Country:US
Mailing Address - Phone:405-373-3122
Mailing Address - Fax:405-373-3443
Practice Address - Street 1:11216 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-8373
Practice Address - Country:US
Practice Address - Phone:405-373-3122
Practice Address - Fax:405-373-3443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2407225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty