Provider Demographics
NPI:1548482854
Name:BALANCED BODIES
Entity type:Organization
Organization Name:BALANCED BODIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMBOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-872-8837
Mailing Address - Street 1:699 PIEDMONT AVE NE
Mailing Address - Street 2:# B
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1400
Mailing Address - Country:US
Mailing Address - Phone:404-872-8837
Mailing Address - Fax:678-244-2155
Practice Address - Street 1:699 PIEDMONT AVE NE
Practice Address - Street 2:# B
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1400
Practice Address - Country:US
Practice Address - Phone:404-872-8837
Practice Address - Fax:678-244-2155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5770100001Medicare NSC
GA35ZCFXBMedicare UPIN