Provider Demographics
NPI:1558542605
Name:BALANCED BODY SERVICES
Entity Type:Organization
Organization Name:BALANCED BODY SERVICES
Other - Org Name:BALANCED BODY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:517-339-7617
Mailing Address - Street 1:383 SHOESMITH RD
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-9790
Mailing Address - Country:US
Mailing Address - Phone:517-339-7617
Mailing Address - Fax:
Practice Address - Street 1:383 SHOESMITH RD
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-9790
Practice Address - Country:US
Practice Address - Phone:517-339-7617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty