Provider Demographics
NPI:1205357936
Name:BALANCED BODY THERAPEUTIC MASSAGE, LLC
Entity Type:Organization
Organization Name:BALANCED BODY THERAPEUTIC MASSAGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LMT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KYMER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:610-653-7701
Mailing Address - Street 1:227 W BROAD ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-5570
Mailing Address - Country:US
Mailing Address - Phone:610-653-7701
Mailing Address - Fax:844-403-3107
Practice Address - Street 1:227 W BROAD ST STE 102
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018
Practice Address - Country:US
Practice Address - Phone:610-653-7701
Practice Address - Fax:833-882-1326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG1705225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty