Provider Demographics
NPI:1295157931
Name:BODY-N-BALANCE
Entity type:Organization
Organization Name:BODY-N-BALANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ECCLESTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:770-552-8852
Mailing Address - Street 1:3005 OLD ALABAMA RD
Mailing Address - Street 2:BUILDING E
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8594
Mailing Address - Country:US
Mailing Address - Phone:770-552-8852
Mailing Address - Fax:770-552-8481
Practice Address - Street 1:3005 OLD ALABAMA RD
Practice Address - Street 2:BUILDING E
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022-8594
Practice Address - Country:US
Practice Address - Phone:770-552-8852
Practice Address - Fax:770-552-8481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty