Provider Demographics
NPI:1235545484
Name:BALANCED BODY CHIROPRACTIC & WELLNESS LLC
Entity Type:Organization
Organization Name:BALANCED BODY CHIROPRACTIC & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-229-1152
Mailing Address - Street 1:PO BOX 583
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-0583
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2201 W 1ST ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-2484
Practice Address - Country:US
Practice Address - Phone:515-964-8547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty