Provider Demographics
NPI:1306090816
Name:BALANCE IN MOTION PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:BALANCE IN MOTION PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:GARDIN
Authorized Official - Last Name:BULKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:415-812-4407
Mailing Address - Street 1:2929 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4126
Mailing Address - Country:US
Mailing Address - Phone:415-702-9206
Mailing Address - Fax:415-341-0380
Practice Address - Street 1:2929 24TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4126
Practice Address - Country:US
Practice Address - Phone:415-702-9206
Practice Address - Fax:415-341-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty