Provider Demographics
| NPI: | 1841342052 |
|---|---|
| Name: | INNOVATIVE BALANCE & THERAPY CLINICS,INC |
| Entity type: | Organization |
| Organization Name: | INNOVATIVE BALANCE & THERAPY CLINICS,INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | GWENDOLYN |
| Authorized Official - Middle Name: | JEAN |
| Authorized Official - Last Name: | BOYD |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | PT |
| Authorized Official - Phone: | 561-207-0989 |
| Mailing Address - Street 1: | 10830 STACEY LN |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BOCA RATON |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 33428-4049 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 561-218-3729 |
| Mailing Address - Fax: | 561-218-0388 |
| Practice Address - Street 1: | 10830 STACEY LN |
| Practice Address - Street 2: | |
| Practice Address - City: | BOCA RATON |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 33428-4049 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 561-703-7884 |
| Practice Address - Fax: | 561-218-0388 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-01-17 |
| Last Update Date: | 2025-09-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
| No | 225000000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Orthotic Fitter | Group - Multi-Specialty | |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
| No | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |