Provider Demographics
NPI:1720225675
Name:BALANCED HEALTH
Entity Type:Organization
Organization Name:BALANCED HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:R
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-779-3220
Mailing Address - Street 1:215 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PECULIAR
Mailing Address - State:MO
Mailing Address - Zip Code:64078-2522
Mailing Address - Country:US
Mailing Address - Phone:816-779-3220
Mailing Address - Fax:816-974-1613
Practice Address - Street 1:215 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PECULIAR
Practice Address - State:MO
Practice Address - Zip Code:64078-2522
Practice Address - Country:US
Practice Address - Phone:816-779-3220
Practice Address - Fax:816-974-1613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008011984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty