Provider Demographics
NPI:1740429604
Name:BALANZE PHYSICAL THERAPY & WELLNESS, LLC
Entity Type:Organization
Organization Name:BALANZE PHYSICAL THERAPY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:508-238-5600
Mailing Address - Street 1:479 TURNPIKE ST
Mailing Address - Street 2:UNIT 7
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1796
Mailing Address - Country:US
Mailing Address - Phone:508-238-5600
Mailing Address - Fax:508-238-5600
Practice Address - Street 1:105 WASHINGTON ST
Practice Address - Street 2:SUITE 10
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1100
Practice Address - Country:US
Practice Address - Phone:508-238-5600
Practice Address - Fax:508-238-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-16
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy