Provider Demographics
NPI:1750159596
Name:A BALANCED APPROACH TO WELLNESS PLLC
Entity type:Organization
Organization Name:A BALANCED APPROACH TO WELLNESS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAVANNAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:SWANLUND
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, PTA
Authorized Official - Phone:309-310-2619
Mailing Address - Street 1:3 STORTZ DR APT A2
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-2072
Mailing Address - Country:US
Mailing Address - Phone:309-310-2619
Mailing Address - Fax:
Practice Address - Street 1:1210 TOWANDA AVE STE 13
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-7415
Practice Address - Country:US
Practice Address - Phone:309-310-2619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty