Provider Demographics
NPI:1972380780
Name:BALANCED FAMILY CHIROPRACTIC LTD
Entity type:Organization
Organization Name:BALANCED FAMILY CHIROPRACTIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YESSENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-538-5075
Mailing Address - Street 1:2109 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:MENDOTA
Mailing Address - State:IL
Mailing Address - Zip Code:61342-1113
Mailing Address - Country:US
Mailing Address - Phone:815-847-8435
Mailing Address - Fax:
Practice Address - Street 1:1301 14TH AVE
Practice Address - Street 2:
Practice Address - City:MENDOTA
Practice Address - State:IL
Practice Address - Zip Code:61342-1001
Practice Address - Country:US
Practice Address - Phone:815-847-8435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty