Provider Demographics
NPI:1922555267
Name:BALANCE POINT PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:BALANCE POINT PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZA
Authorized Official - Middle Name:GRANNIS
Authorized Official - Last Name:LUSSIER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:207-233-9272
Mailing Address - Street 1:945 SAWYER ST
Mailing Address - Street 2:
Mailing Address - City:S PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6535
Mailing Address - Country:US
Mailing Address - Phone:207-233-9272
Mailing Address - Fax:
Practice Address - Street 1:945 SAWYER ST
Practice Address - Street 2:
Practice Address - City:S PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-6535
Practice Address - Country:US
Practice Address - Phone:207-233-9272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-03
Last Update Date:2016-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT1822225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty