Provider Demographics
NPI:1730262650
Name:CENTER OF BALANCE PHYSICAL THERAPY & PILATES P.C.
Entity type:Organization
Organization Name:CENTER OF BALANCE PHYSICAL THERAPY & PILATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:970-249-6811
Mailing Address - Street 1:646 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3707
Mailing Address - Country:US
Mailing Address - Phone:970-249-6811
Mailing Address - Fax:970-249-5184
Practice Address - Street 1:646 N 1ST ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-3707
Practice Address - Country:US
Practice Address - Phone:970-249-6811
Practice Address - Fax:970-249-5184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3989261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO801842Medicare ID - Type Unspecified