Provider Demographics
NPI:1902386816
Name:BACK TO BALANCE PHYSIOTHERAPY
Entity Type:Organization
Organization Name:BACK TO BALANCE PHYSIOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:ULRIKE
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-692-0601
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:
Mailing Address - City:OREGON HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95962-0858
Mailing Address - Country:US
Mailing Address - Phone:530-692-0601
Mailing Address - Fax:530-692-2278
Practice Address - Street 1:9230 MARYSVILLE RD
Practice Address - Street 2:
Practice Address - City:OREGON HOUSE
Practice Address - State:CA
Practice Address - Zip Code:95962-9705
Practice Address - Country:US
Practice Address - Phone:530-692-0601
Practice Address - Fax:530-692-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty