Provider Demographics
NPI:1457049231
Name:IN BALANCE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:IN BALANCE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:VERNA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:484-459-0780
Mailing Address - Street 1:84 THEATRE DR STE 500
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-3131
Mailing Address - Country:US
Mailing Address - Phone:904-770-2552
Mailing Address - Fax:
Practice Address - Street 1:84 THEATRE DR STE 500
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-3131
Practice Address - Country:US
Practice Address - Phone:904-770-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy