Provider Demographics
NPI:1417458241
Name:MID AMERICA BALANCE INSTITUTE INC
Entity Type:Organization
Organization Name:MID AMERICA BALANCE INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WOODWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:816-795-6999
Mailing Address - Street 1:4900 S ARROWHEAD DR STE B
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6990
Mailing Address - Country:US
Mailing Address - Phone:816-795-6999
Mailing Address - Fax:
Practice Address - Street 1:123 NE 91ST ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-3329
Practice Address - Country:US
Practice Address - Phone:816-246-1456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MID AMERICA BALANCE INSTITUTE INCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty