Provider Demographics
NPI:1871865188
Name:BODY BALANCED CARE PLLC
Entity type:Organization
Organization Name:BODY BALANCED CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-224-3031
Mailing Address - Street 1:3315 W MAYFLOWER WAY STE 4
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-2927
Mailing Address - Country:US
Mailing Address - Phone:801-224-3031
Mailing Address - Fax:801-890-3924
Practice Address - Street 1:3315 W MAYFLOWER WAY STE 4
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-2927
Practice Address - Country:US
Practice Address - Phone:801-224-3031
Practice Address - Fax:801-890-3924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3085392-4405261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center