Provider Demographics
NPI:1598381634
Name:BODY BALANCE, LLC
Entity Type:Organization
Organization Name:BODY BALANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:ATC, CMT
Authorized Official - Phone:720-252-7940
Mailing Address - Street 1:PO BOX 270673
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-0011
Mailing Address - Country:US
Mailing Address - Phone:720-288-2625
Mailing Address - Fax:
Practice Address - Street 1:8061 SHAFFER PKWY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3762
Practice Address - Country:US
Practice Address - Phone:720-288-2625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty