Provider Demographics
NPI:1104455377
Name:DIZZY BRAIN AND BALANCE SPECIALISTS LLC
Entity type:Organization
Organization Name:DIZZY BRAIN AND BALANCE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT, VRT
Authorized Official - Phone:267-210-9538
Mailing Address - Street 1:484 MAPLE POINT DR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1473
Mailing Address - Country:US
Mailing Address - Phone:267-210-9538
Mailing Address - Fax:
Practice Address - Street 1:484 MAPLE POINT DR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1473
Practice Address - Country:US
Practice Address - Phone:267-210-9538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy