Provider Demographics
NPI:1821691908
Name:BALANCED LIFE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BALANCED LIFE CHIROPRACTIC LLC
Other - Org Name:WELL HEALTH & CHIROPRACTIC SPRING HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KERNODLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-593-5484
Mailing Address - Street 1:4920 PORT ROYAL RD STE C
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-2856
Mailing Address - Country:US
Mailing Address - Phone:931-451-7230
Mailing Address - Fax:931-451-7958
Practice Address - Street 1:4920 PORT ROYAL RD STE C
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-2856
Practice Address - Country:US
Practice Address - Phone:931-451-7230
Practice Address - Fax:931-451-7958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care