Provider Demographics
NPI:1568585545
Name:WHOLE BODY BALANCE, INC.
Entity Type:Organization
Organization Name:WHOLE BODY BALANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-444-0192
Mailing Address - Street 1:5420 ARAPAHOE AVE STE E
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1250
Mailing Address - Country:US
Mailing Address - Phone:303-444-0192
Mailing Address - Fax:303-442-1794
Practice Address - Street 1:5420 ARAPAHOE AVE STE E
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1250
Practice Address - Country:US
Practice Address - Phone:303-444-0192
Practice Address - Fax:303-442-1794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty