Provider Demographics
NPI:1881614154
Name:BALANCE CENTERS OF AMERICA
Entity type:Organization
Organization Name:BALANCE CENTERS OF AMERICA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:BUSKIRK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:847-518-0442
Mailing Address - Street 1:311 N BUFFALO DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-0375
Mailing Address - Country:US
Mailing Address - Phone:702-341-0606
Mailing Address - Fax:702-341-1040
Practice Address - Street 1:311 N BUFFALO DR
Practice Address - Street 2:SUITE C
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-0375
Practice Address - Country:US
Practice Address - Phone:702-341-0606
Practice Address - Fax:702-341-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV34381Medicare ID - Type Unspecified