Provider Demographics
NPI:1811029556
Name:NATURAL BALANCE WELLNESS CENTER
Entity Type:Organization
Organization Name:NATURAL BALANCE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC, ND
Authorized Official - Phone:404-843-0880
Mailing Address - Street 1:130 ALLEN RD NE
Mailing Address - Street 2:SUITE D
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4842
Mailing Address - Country:US
Mailing Address - Phone:404-843-0880
Mailing Address - Fax:404-843-6445
Practice Address - Street 1:130 ALLEN RD NE
Practice Address - Street 2:SUITE D
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4842
Practice Address - Country:US
Practice Address - Phone:404-843-0880
Practice Address - Fax:404-843-6445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
61133700OtherOWCP
61133700OtherOWCP
GRP7023Medicare ID - Type Unspecified