Provider Demographics
NPI:1851626055
Name:BALANCE CHIROPRACTIC AND REHAB PC
Entity Type:Organization
Organization Name:BALANCE CHIROPRACTIC AND REHAB PC
Other - Org Name:BALANCE CHIROPRACTIC AND REHAB P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:POZARNSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-201-8472
Mailing Address - Street 1:3140 BLUESTEM DR STE 103
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8010
Mailing Address - Country:US
Mailing Address - Phone:952-201-8472
Mailing Address - Fax:701-893-7876
Practice Address - Street 1:3140 BLUESTEM DR STE 103
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8010
Practice Address - Country:US
Practice Address - Phone:701-893-7878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND832111N00000X
111N00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND10898Medicaid
ND10898Medicaid