Provider Demographics
NPI:1942538723
Name:INNER BALANCE ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:INNER BALANCE ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SACHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-931-8272
Mailing Address - Street 1:3405 PENROSE PL
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1818
Mailing Address - Country:US
Mailing Address - Phone:303-931-8294
Mailing Address - Fax:303-442-0746
Practice Address - Street 1:3405 PENROSE PL
Practice Address - Street 2:SUITE 103
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1818
Practice Address - Country:US
Practice Address - Phone:303-931-8294
Practice Address - Fax:303-442-0746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-06
Last Update Date:2009-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO510171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty