1932822178 NPI number — RHYTHM AND BALANCE, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932822178 NPI number — RHYTHM AND BALANCE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RHYTHM AND BALANCE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932822178
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5322 COUNTY ROAD 292 E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KILGORE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75662-1793
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-610-5752
Provider Business Mailing Address Fax Number:
800-589-1824

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 ENTERPRISE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONGVIEW
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75604-5447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-610-5752
Provider Business Practice Location Address Fax Number:
800-589-1824
Provider Enumeration Date:
09/22/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
BRENDA
Authorized Official Middle Name:
MCGEE
Authorized Official Title or Position:
COUNSELOR
Authorized Official Telephone Number:
251-610-5752

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)