Provider Demographics
NPI:1851709562
Name:BALANCED BODY HOLISTIC HEALTH, LLC.
Entity Type:Organization
Organization Name:BALANCED BODY HOLISTIC HEALTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:RENTAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:913-832-3030
Mailing Address - Street 1:550 E LAKOTA ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-8529
Mailing Address - Country:US
Mailing Address - Phone:913-832-3030
Mailing Address - Fax:
Practice Address - Street 1:531 N MUR LEN RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1246
Practice Address - Country:US
Practice Address - Phone:913-839-2389
Practice Address - Fax:913-839-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty