Provider Demographics
NPI:1811422447
Name:HOLISTIC BALANCE ACUPUNCTURE
Entity Type:Organization
Organization Name:HOLISTIC BALANCE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEYS
Authorized Official - Suffix:
Authorized Official - Credentials:LICAC
Authorized Official - Phone:978-846-5123
Mailing Address - Street 1:69 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-4404
Mailing Address - Country:US
Mailing Address - Phone:978-846-5123
Mailing Address - Fax:
Practice Address - Street 1:78 MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:PEPPERELL
Practice Address - State:MA
Practice Address - Zip Code:01463-1561
Practice Address - Country:US
Practice Address - Phone:978-846-5123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA263786261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center