Provider Demographics
NPI:1104364777
Name:BACK TO BALANCE NATURAL HEALING CENTER
Entity Type:Organization
Organization Name:BACK TO BALANCE NATURAL HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:LILLIAN
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-239-7320
Mailing Address - Street 1:10505 WAYZATA BLVD
Mailing Address - Street 2:SUITE102
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1502
Mailing Address - Country:US
Mailing Address - Phone:952-236-7610
Mailing Address - Fax:952-426-0674
Practice Address - Street 1:10505 WAYZATA BLVD
Practice Address - Street 2:SUITE102
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1502
Practice Address - Country:US
Practice Address - Phone:952-236-7610
Practice Address - Fax:952-426-0674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4554111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty