Provider Demographics
NPI:1861001810
Name:BALANCE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BALANCE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLUTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-338-5901
Mailing Address - Street 1:4701 GASTON CIR
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53527-9765
Mailing Address - Country:US
Mailing Address - Phone:608-338-5901
Mailing Address - Fax:
Practice Address - Street 1:6075 GEMINI DR STE 101
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-3013
Practice Address - Country:US
Practice Address - Phone:608-338-5901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service