Provider Demographics
NPI:1457052144
Name:BALANCE PHYSICAL THERAPY AND WELLNESS
Entity Type:Organization
Organization Name:BALANCE PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:BROOKS
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-693-5660
Mailing Address - Street 1:401 SEACOAST PKWY UNIT D
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8263
Mailing Address - Country:US
Mailing Address - Phone:843-969-2201
Mailing Address - Fax:843-969-2202
Practice Address - Street 1:401 SEACOAST PKWY UNIT D
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8263
Practice Address - Country:US
Practice Address - Phone:843-969-2201
Practice Address - Fax:843-969-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty