Individual
DR. CHARISSE BALANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
107 CALIFORNIA AVE, MILL VALLEY, CA 94941-3588
(805) 699-6423
Mailing address
203 FLAMINGO RD # 215, MILL VALLEY, CA 94941-3603
(916) 612-0908
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
36803
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36803
PT LICENSE NUMBER
CA
Enumeration date
07/06/2021
Last updated
07/06/2021
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