Organization
PRO BALANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GILGIA PRUMBS PT (MEMBER)
(423) 246-7272
Entity
Organization
Contact information
Practice address
2408 FORT HENRY DRIVE, KINGSPORT, TN 37664
(423) 246-7272
(423) 246-2803
Mailing address
2408 FORT HENRY DRIVE, KINGSPORT, TN 37664
(423) 246-7272
(423) 246-2803
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
PRO16
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454327
—
TN
Enumeration date
09/20/2007
Last updated
01/07/2008
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