Provider Demographics
NPI:1578340790
Name:BACK TO BALANCE ACUPUNCTURE AND WELLNESS LLC
Entity Type:Organization
Organization Name:BACK TO BALANCE ACUPUNCTURE AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:NEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TURK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:202-492-3367
Mailing Address - Street 1:11511 WATERHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-4467
Mailing Address - Country:US
Mailing Address - Phone:202-492-3367
Mailing Address - Fax:
Practice Address - Street 1:1033 STERLING RD STE 105
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3837
Practice Address - Country:US
Practice Address - Phone:571-249-5859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty