Provider Demographics
NPI:1588192702
Name:CORE BALANCE PLC
Entity Type:Organization
Organization Name:CORE BALANCE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:EBY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, MED
Authorized Official - Phone:269-352-6045
Mailing Address - Street 1:6825 BENTLEY DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-5916
Mailing Address - Country:US
Mailing Address - Phone:269-352-6045
Mailing Address - Fax:
Practice Address - Street 1:2026 PARKVIEW AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-2834
Practice Address - Country:US
Practice Address - Phone:269-352-6045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty