Provider Demographics
NPI:1568699155
Name:BALANCE & MOTION WELLNESS CLINIC, L.L.C.
Entity Type:Organization
Organization Name:BALANCE & MOTION WELLNESS CLINIC, L.L.C.
Other - Org Name:DR. CYNTHIA HOWARD, D.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:BS, DC
Authorized Official - Phone:563-505-1127
Mailing Address - Street 1:121 S MISSISSIPPI ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BLUE GRASS
Mailing Address - State:IA
Mailing Address - Zip Code:52726-9306
Mailing Address - Country:US
Mailing Address - Phone:563-505-1127
Mailing Address - Fax:563-484-5304
Practice Address - Street 1:121 S MISSISSIPPI ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BLUE GRASS
Practice Address - State:IA
Practice Address - Zip Code:52726-9306
Practice Address - Country:US
Practice Address - Phone:563-505-1127
Practice Address - Fax:563-484-5304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0746818Medicaid
IA0746818Medicaid