Provider Demographics
NPI:1225362312
Name:IN BALANCE REHAB LLC
Entity Type:Organization
Organization Name:IN BALANCE REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCALES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:321-799-0030
Mailing Address - Street 1:109 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-4009
Mailing Address - Country:US
Mailing Address - Phone:321-799-0030
Mailing Address - Fax:321-799-9238
Practice Address - Street 1:109 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-4009
Practice Address - Country:US
Practice Address - Phone:321-799-0030
Practice Address - Fax:321-799-9238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5679225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty