Provider Demographics
NPI:1255140471
Name:BODY IN BALANCE MASSAGE THERAPY & ESTHETICS, LLC
Entity type:Organization
Organization Name:BODY IN BALANCE MASSAGE THERAPY & ESTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:S
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MMT
Authorized Official - Phone:614-395-5091
Mailing Address - Street 1:3208 VILLAGE EAST DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72120-2297
Mailing Address - Country:US
Mailing Address - Phone:614-395-5091
Mailing Address - Fax:
Practice Address - Street 1:1310 JOHN HARDEN DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-3144
Practice Address - Country:US
Practice Address - Phone:501-515-4324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty