Provider Demographics
NPI:1689262677
Name:BALANCED JOURNEY CHIROPRACTIC & ACUPUNCTURE PLLC
Entity Type:Organization
Organization Name:BALANCED JOURNEY CHIROPRACTIC & ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTOSH-HEACOX
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-680-2031
Mailing Address - Street 1:PO BOX 829
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:ND
Mailing Address - Zip Code:58054-0829
Mailing Address - Country:US
Mailing Address - Phone:701-680-2031
Mailing Address - Fax:
Practice Address - Street 1:15 11TH AVE W
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:ND
Practice Address - Zip Code:58054-4306
Practice Address - Country:US
Practice Address - Phone:701-680-2031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty