Provider Demographics
NPI:1932684933
Name:NORTHERN HOPE BETTER BALANCE
Entity Type:Organization
Organization Name:NORTHERN HOPE BETTER BALANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRABER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-232-3178
Mailing Address - Street 1:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:NISSWA
Mailing Address - State:MN
Mailing Address - Zip Code:56468-0505
Mailing Address - Country:US
Mailing Address - Phone:218-232-3178
Mailing Address - Fax:
Practice Address - Street 1:25503 MAIN ST
Practice Address - Street 2:
Practice Address - City:NISSWA
Practice Address - State:MN
Practice Address - Zip Code:56468-5000
Practice Address - Country:US
Practice Address - Phone:218-232-3178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty