Provider Demographics
NPI:1720029598
Name:BALANCE POINT VESTIBULAR REHABILITATION LLC
Entity Type:Organization
Organization Name:BALANCE POINT VESTIBULAR REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERCY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:719-667-0666
Mailing Address - Street 1:7606 N UNION BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3850
Mailing Address - Country:US
Mailing Address - Phone:719-667-0666
Mailing Address - Fax:719-594-5658
Practice Address - Street 1:7606 N UNION BLVD STE 140
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3873
Practice Address - Country:US
Practice Address - Phone:719-667-0666
Practice Address - Fax:719-594-5658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONOT REQUIRED IN COLO225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC546638Medicare ID - Type Unspecified