Provider Demographics
NPI:1891812129
Name:BALANCED CARE PC
Entity Type:Organization
Organization Name:BALANCED CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-782-0429
Mailing Address - Street 1:22 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2802
Mailing Address - Country:US
Mailing Address - Phone:406-782-0429
Mailing Address - Fax:
Practice Address - Street 1:22 W FRONT ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2802
Practice Address - Country:US
Practice Address - Phone:406-782-0429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTT89329Medicare UPIN
MT000083777Medicare Oscar/Certification