Provider Demographics
NPI:1629659420
Name:BODY IN BALANCE CHIROPRACTIC & WELLNESS, PC
Entity Type:Organization
Organization Name:BODY IN BALANCE CHIROPRACTIC & WELLNESS, PC
Other - Org Name:BODY IN BALANCE CHIROPRACTIC & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:A
Authorized Official - Last Name:DARGATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-878-2639
Mailing Address - Street 1:1002 14TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-5328
Mailing Address - Country:US
Mailing Address - Phone:605-878-2639
Mailing Address - Fax:605-878-2640
Practice Address - Street 1:1002 14TH ST SE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-5328
Practice Address - Country:US
Practice Address - Phone:605-878-2639
Practice Address - Fax:605-878-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty