Provider Demographics
NPI:1396394052
Name:EQUILIBRIUM MASSAGE CENTER LLC
Entity Type:Organization
Organization Name:EQUILIBRIUM MASSAGE CENTER LLC
Other - Org Name:BALANCE BY TOUCH MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MONALIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGHERIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-619-2290
Mailing Address - Street 1:6400 BANNINGTON RD STE A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-1327
Mailing Address - Country:US
Mailing Address - Phone:704-753-7689
Mailing Address - Fax:704-970-4121
Practice Address - Street 1:6400 BANNINGTON RD STE A
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-1327
Practice Address - Country:US
Practice Address - Phone:704-753-7689
Practice Address - Fax:704-970-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty