Provider Demographics
NPI:1326421686
Name:BALANCE CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:BALANCE CHIROPRACTIC, LLC
Other - Org Name:BALANCE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILES
Authorized Official - Middle Name:
Authorized Official - Last Name:COLAPRETE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-985-5833
Mailing Address - Street 1:4066 SHELBURNE RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-6905
Mailing Address - Country:US
Mailing Address - Phone:802-985-5833
Mailing Address - Fax:802-985-2385
Practice Address - Street 1:4066 SHELBURNE RD
Practice Address - Street 2:SUITE 8
Practice Address - City:SHELBURNE
Practice Address - State:VT
Practice Address - Zip Code:05482-6905
Practice Address - Country:US
Practice Address - Phone:802-985-5833
Practice Address - Fax:802-985-2385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006.0091379111NS0005X
111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1021786Medicaid
VT1021786Medicaid