Provider Demographics
NPI:1629765698
Name:ELIZABETH OMALLEY
Entity Type:Organization
Organization Name:ELIZABETH OMALLEY
Other - Org Name:BALANCED PILATES BY BETSY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OMALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:989-430-0755
Mailing Address - Street 1:810 E ASHMAN ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-4505
Mailing Address - Country:US
Mailing Address - Phone:989-486-1232
Mailing Address - Fax:
Practice Address - Street 1:810 E ASHMAN ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-4505
Practice Address - Country:US
Practice Address - Phone:989-486-1232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty