Provider Demographics
NPI:1013779669
Name:A BALANCED ACT, LLP
Entity Type:Organization
Organization Name:A BALANCED ACT, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:REYES
Authorized Official - Last Name:CLEGG
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:208-220-9649
Mailing Address - Street 1:HC 74 BOX 4111
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84731-4116
Mailing Address - Country:US
Mailing Address - Phone:208-220-9649
Mailing Address - Fax:
Practice Address - Street 1:579 W 900 S
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:UT
Practice Address - Zip Code:84731-4116
Practice Address - Country:US
Practice Address - Phone:208-220-9649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty