Provider Demographics
NPI:1265525836
Name:BODY IN BALANCE PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:BODY IN BALANCE PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAVINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-746-0722
Mailing Address - Street 1:642 S ALASKA ST STE 209
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6378
Mailing Address - Country:US
Mailing Address - Phone:907-746-0722
Mailing Address - Fax:907-746-0732
Practice Address - Street 1:642 S ALASKA ST STE 209
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6378
Practice Address - Country:US
Practice Address - Phone:907-746-0722
Practice Address - Fax:907-746-0732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK153327Medicare ID - Type UnspecifiedMEDICARE NUMBER