Provider Demographics
NPI:1134565153
Name:TRUE BALANCE CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:TRUE BALANCE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TEAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LMT
Authorized Official - Phone:503-987-1696
Mailing Address - Street 1:51669 COLUMBIA RIVER HWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-4508
Mailing Address - Country:US
Mailing Address - Phone:503-987-1696
Mailing Address - Fax:503-208-7202
Practice Address - Street 1:51669 COLUMBIA RIVER HWY
Practice Address - Street 2:SUITE 130
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-4508
Practice Address - Country:US
Practice Address - Phone:503-987-1696
Practice Address - Fax:503-208-7202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-16
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4092111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR161045OtherMEDICARE PTAN