Provider Demographics
NPI:1154599207
Name:BALANCEPOINT HEALTH CENTER, PC
Entity type:Organization
Organization Name:BALANCEPOINT HEALTH CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:KATHRYN
Authorized Official - Last Name:RISTY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-476-1116
Mailing Address - Street 1:1829 NEBRASKA AVE
Mailing Address - Street 2:BALANCEPOINT HEALTH CENTER, P.C.
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527
Mailing Address - Country:US
Mailing Address - Phone:541-476-1116
Mailing Address - Fax:541-476-1720
Practice Address - Street 1:1829 NEBRASKA AVE
Practice Address - Street 2:BALANCEPOINT HEALTH CENTER, P.C.
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527
Practice Address - Country:US
Practice Address - Phone:541-476-1116
Practice Address - Fax:541-476-1720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR273378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU91058Medicare UPIN
ORR131382Medicare PIN