| Balanced Life Chiropractic Llc | |
|
9028 Prince William St Ste 2a Manassas VA 20110-5664 | |
| (703) 334-8597 | |
| Not Available |
| Full Name | Balanced Life Chiropractic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9028 Prince William St Ste 2a, Manassas, Virginia |
| Authorized Official Name and Position | Jacqueline Merced Gonzalez (OWNER/CHIROPRACTOR) |
| Authorized Official Contact | 4044099010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Balanced Life Chiropractic Llc 9028 Prince William St Ste 2a Manassas VA 20110-5664 Ph: (703) 334-8597 | Balanced Life Chiropractic Llc 9028 Prince William St Ste 2a Manassas VA 20110-5664 Ph: (703) 334-8597 |
| NPI Number | 1821567652 |
|---|---|
| Provider Enumeration Date | 11/21/2018 |
| Last Update Date | 11/21/2018 |
| Medicare PECOS PAC ID | 1355797200 |
|---|---|
| Medicare Enrollment ID | O20231027003134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821567652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jacqueline Merced-gonzalez |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1386041614 PECOS PAC ID: 5890014997 Enrollment ID: I20150511002124 |
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