Provider Demographics
NPI:1831579499
Name:BALANCED CARE PHYSCIAL THERAPY LLC
Entity type:Organization
Organization Name:BALANCED CARE PHYSCIAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-338-1680
Mailing Address - Street 1:1110 S TALBOT ST
Mailing Address - Street 2:SUITE#5
Mailing Address - City:ST MICHAELS
Mailing Address - State:MD
Mailing Address - Zip Code:21663-2606
Mailing Address - Country:US
Mailing Address - Phone:240-338-1680
Mailing Address - Fax:
Practice Address - Street 1:1110 S TALBOT ST
Practice Address - Street 2:SUITE#5
Practice Address - City:ST MICHAELS
Practice Address - State:MD
Practice Address - Zip Code:21663-2606
Practice Address - Country:US
Practice Address - Phone:240-338-1680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16975261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy