Provider Demographics
NPI:1952093601
Name:MADISON BALANCE CLINICS LLC
Entity Type:Organization
Organization Name:MADISON BALANCE CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAMM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:608-709-7511
Mailing Address - Street 1:847 HARPER DR
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1735
Mailing Address - Country:US
Mailing Address - Phone:920-318-1171
Mailing Address - Fax:
Practice Address - Street 1:7404 MINERAL POINT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1710
Practice Address - Country:US
Practice Address - Phone:608-709-7511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy