Provider Demographics
NPI:1740778455
Name:BASIC BALANCE, PLLC
Entity Type:Organization
Organization Name:BASIC BALANCE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:603-721-9388
Mailing Address - Street 1:160 UPPER TROY RD
Mailing Address - Street 2:
Mailing Address - City:FITZWILLIAM
Mailing Address - State:NH
Mailing Address - Zip Code:03447-3146
Mailing Address - Country:US
Mailing Address - Phone:603-721-9388
Mailing Address - Fax:
Practice Address - Street 1:103 ROXBURY ST STE 200D
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3800
Practice Address - Country:US
Practice Address - Phone:603-721-9388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH249171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty