Basic Information
| Provider Information | |||||||||
| NPI: | 1306388442 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MAXIMAL BALANCE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9950 W 80TH AVE | ||||||||
| Address2: | STE 16 | ||||||||
| City: | ARVADA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800053927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7206889233 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9950 W 80TH AVE | ||||||||
| Address2: | STE 16 | ||||||||
| City: | ARVADA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800053927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7206889233 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2016 | ||||||||
| LastUpdateDate: | 11/07/2016 | ||||||||
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| AuthorizedOfficialLastName: | STRAUSSER | ||||||||
| AuthorizedOfficialFirstName: | TEREZA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PHYSICAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 7206889233 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PT, DPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 8990 | CO | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.