Provider Demographics
NPI:1235445412
Name:BALANCE CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:BALANCE CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EVA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WHITMORE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DC
Authorized Official - Phone:510-450-0701
Mailing Address - Street 1:4168 PIEDMONT AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5172
Mailing Address - Country:US
Mailing Address - Phone:510-450-0701
Mailing Address - Fax:510-547-1039
Practice Address - Street 1:4168 PIEDMONT AVE
Practice Address - Street 2:SUITE E
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5172
Practice Address - Country:US
Practice Address - Phone:510-450-0701
Practice Address - Fax:510-547-1039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28197111NN1001X
UT7689824-1202111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty