Organization
LIFESTYLE BALANCE HEALTHCARE TRUST
Active
Other names
Lifestyle Balance Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY ROSS JOHNSTON D.C. (ACTING CHIEF EXECUTIVE OFFICER)
(480) 962-4649
Entity
Organization
Contact information
Practice address
65 E 1ST AVE STE 101, MESA, AZ 85210-1456
(480) 962-4649
(480) 962-8617
Mailing address
65 E 1ST AVE STE 101, MESA, AZ 85210-1456
(480) 962-4649
(480) 962-8617
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
07/03/2007
Last updated
08/22/2020
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