Provider Demographics
NPI:1497391411
Name:BETTER BALANCE ACUPUNCTURE
Entity Type:Organization
Organization Name:BETTER BALANCE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKKETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-864-3242
Mailing Address - Street 1:10721 FAIR OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-7212
Mailing Address - Country:US
Mailing Address - Phone:916-864-3242
Mailing Address - Fax:
Practice Address - Street 1:10721 FAIR OAKS BLVD
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7212
Practice Address - Country:US
Practice Address - Phone:916-864-3242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty