Provider Demographics
NPI:1689438749
Name:A JUST BALANCE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:A JUST BALANCE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ALLISON
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:864-702-8090
Mailing Address - Street 1:3740 BOILING SPRINGS RD # 127
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-5716
Mailing Address - Country:US
Mailing Address - Phone:864-702-8090
Mailing Address - Fax:
Practice Address - Street 1:160 FARMHOUSE RD
Practice Address - Street 2:
Practice Address - City:CAMPOBELLO
Practice Address - State:SC
Practice Address - Zip Code:29322-9344
Practice Address - Country:US
Practice Address - Phone:864-702-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty