Provider Demographics
NPI:1194235580
Name:IN BALANCE IN CONTROL, L.L.C.
Entity type:Organization
Organization Name:IN BALANCE IN CONTROL, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LOC/MASSAGE THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:FREY
Authorized Official - Suffix:II
Authorized Official - Credentials:LMT
Authorized Official - Phone:214-536-2955
Mailing Address - Street 1:4621 S COOPER STREET
Mailing Address - Street 2:SUITE 131-348
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:75017-5815
Mailing Address - Country:US
Mailing Address - Phone:214-536-2955
Mailing Address - Fax:
Practice Address - Street 1:1402 W MAYFIELD RD
Practice Address - Street 2:SUITE 420
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015
Practice Address - Country:US
Practice Address - Phone:214-536-2955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT112652225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty