Provider Demographics
NPI:1225245749
Name:BALANCED PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:BALANCED PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CHOWANIEC
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:602-432-2567
Mailing Address - Street 1:12940 W CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-5184
Mailing Address - Country:US
Mailing Address - Phone:602-432-2567
Mailing Address - Fax:
Practice Address - Street 1:12940 W CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-5184
Practice Address - Country:US
Practice Address - Phone:602-432-2567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5529261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy