Organization
EQUILIBRIUM BALANCE PERFORMANCE CENTER PHYSICAL THERAPY A PROF. CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY M. GRIFFIN M.S.,P.T. (PRESIDENT)
(805) 339-9718
Entity
Organization
Contact information
Practice address
1673 DONLON ST STE 201, VENTURA, CA 93003-5668
(805) 339-9718
(805) 339-9728
Mailing address
1673 DONLON ST STE 201, VENTURA, CA 93003-5668
(805) 339-9718
(805) 339-9728
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT 27784
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ62926Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
08/06/2007
Last updated
03/02/2018
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