Organization
BALANCE MEDICAL AND WELLNESS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PREZIOSO (OWNER)
(609) 703-5097
Entity
Organization
Contact information
Practice address
14200 MADISON AVE, LAKEWOOD, OH 44107-4510
(216) 577-1003
Mailing address
14200 MADISON AVE, LAKEWOOD, OH 44107-4510
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
36.003502
OH
Other
Enumeration date
09/19/2016
Last updated
01/05/2017
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