Provider Demographics
NPI:1780241828
Name:BALANCED CHIROPRACTIC CENTER LLC
Entity type:Organization
Organization Name:BALANCED CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-957-6691
Mailing Address - Street 1:134 AVE DOMENECH
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3502
Mailing Address - Country:US
Mailing Address - Phone:787-467-1017
Mailing Address - Fax:
Practice Address - Street 1:134 AVE DOMENECH
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3502
Practice Address - Country:US
Practice Address - Phone:787-467-1017
Practice Address - Fax:787-957-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty