Provider Demographics
NPI:1184837684
Name:THE BALANCED BODY CENTER
Entity Type:Organization
Organization Name:THE BALANCED BODY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARNONE
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:704-849-9393
Mailing Address - Street 1:PO BOX 2150
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28106-2150
Mailing Address - Country:US
Mailing Address - Phone:704-849-9393
Mailing Address - Fax:704-845-8589
Practice Address - Street 1:10550 INDEPENDENCE POINTE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2690
Practice Address - Country:US
Practice Address - Phone:704-849-9393
Practice Address - Fax:704-845-8589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2073111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC245-5860Medicare PIN