Provider Demographics
NPI:1568947232
Name:INNER BALANCE ACUPUNCTURE
Entity Type:Organization
Organization Name:INNER BALANCE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FUESTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-595-2164
Mailing Address - Street 1:274 SOUTHLAND DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1946
Mailing Address - Country:US
Mailing Address - Phone:859-595-2164
Mailing Address - Fax:855-237-3143
Practice Address - Street 1:274 SOUTHLAND DR STE 101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1946
Practice Address - Country:US
Practice Address - Phone:859-595-2164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-28
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty