1700093994 NPI number — BALANCE CHIROPRACTIC & WELLNESS CENTER, P.C.

Table of content: MRS. REBECCA LYNN BRINKS OTRL (NPI 1164925608)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700093994 NPI number — BALANCE CHIROPRACTIC & WELLNESS CENTER, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BALANCE CHIROPRACTIC & WELLNESS CENTER, P.C.
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:
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:
1700093994
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
145 WATERMAN ST
Provider Second Line Business Mailing Address:
LOWER LEVEL
Provider Business Mailing Address City Name:
PROVIDENCE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02906-2128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-831-2000
Provider Business Mailing Address Fax Number:
401-831-2026

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
145 WATERMAN ST
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02906-2128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-831-2000
Provider Business Practice Location Address Fax Number:
401-831-2026
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SALINGER
Authorized Official First Name:
AARON
Authorized Official Middle Name:
LOGAN
Authorized Official Title or Position:
CHIROPRACTIC PHYSICIAN
Authorized Official Telephone Number:
401-831-2000

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DCP00550 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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