Provider Demographics
NPI:1992947782
Name:KINETIC BALANCE THERAPEUTIC MASSAGE LLP
Entity type:Organization
Organization Name:KINETIC BALANCE THERAPEUTIC MASSAGE LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:THUY
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-907-8870
Mailing Address - Street 1:2024 SHEPHERDS GLEN LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-6791
Mailing Address - Country:US
Mailing Address - Phone:817-907-8870
Mailing Address - Fax:940-321-0173
Practice Address - Street 1:2024 SHEPHERDS GLEN LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6791
Practice Address - Country:US
Practice Address - Phone:817-907-8870
Practice Address - Fax:940-321-0173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID