# VITAL BALANCE OSTEOPATHY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VITAL BALANCE OSTEOPATHY, PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1760097927
- **Legal business name:** VITAL BALANCE OSTEOPATHY, PLLC
- **Authorized official:** DR. LISA PRESTON DO (OWNER, PRESIDEN, PHYSICIAN)
- **Authorized official phone:** (917) 338-1884

## Contact information

- **Practice address:** 10 BOND STREET, STE 1, \#290, GREAT NECK, NY 11021
- **Practice address phone:** (917) 338-1884
- **Mailing address:** 10 BOND STREET, STE 1, \#290, GREAT NECK, NY 11021
- **Mailing address phone:** (917) 338-1884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | — | Yes |
| 2084P0800X | Psychiatry Physician | — | — | — |

## Other

- **Enumeration date:** 09/14/2020
- **Last updated:** 09/14/2020