Provider Demographics
NPI:1447634910
Name:HEALTH & BALANCE CHIROPRACTIC CLINIC, LLC
Entity type:Organization
Organization Name:HEALTH & BALANCE CHIROPRACTIC CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:540-463-2462
Mailing Address - Street 1:17 S RANDOLPH ST
Mailing Address - Street 2:A
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2526
Mailing Address - Country:US
Mailing Address - Phone:540-463-2462
Mailing Address - Fax:540-463-2469
Practice Address - Street 1:17 S RANDOLPH ST
Practice Address - Street 2:A
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2526
Practice Address - Country:US
Practice Address - Phone:540-463-2462
Practice Address - Fax:540-463-2469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557072305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service