Provider Demographics
NPI:1265979488
Name:PEAK BALANCE FAMILY WELLNESS PLLC
Entity type:Organization
Organization Name:PEAK BALANCE FAMILY WELLNESS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-978-1270
Mailing Address - Street 1:6120 BARNES ROAD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922
Mailing Address - Country:US
Mailing Address - Phone:719-344-9270
Mailing Address - Fax:719-203-5271
Practice Address - Street 1:6120 BARNES ROAD
Practice Address - Street 2:SUITE 160
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80922
Practice Address - Country:US
Practice Address - Phone:719-344-9270
Practice Address - Fax:719-203-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6477261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center