| Inner Balance Integrative Medicine, Llc | |
|
65 Walnut St Suite 380 Wellesley MA 02481-2118 | |
| (781) 239-9900 | |
| (781) 239-9953 |
| Full Name | Inner Balance Integrative Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 65 Walnut St, Wellesley, Massachusetts |
| Authorized Official Name and Position | John Bordiuk (OWNER) |
| Authorized Official Contact | 7814549014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Balance Integrative Medicine, Llc 65 Walnut St Suite 380 Wellesley MA 02481-2118 Ph: (781) 454-9014 | Inner Balance Integrative Medicine, Llc 65 Walnut St Suite 380 Wellesley MA 02481-2118 Ph: (781) 239-9900 |
| NPI Number | 1487917993 |
|---|---|
| Provider Enumeration Date | 06/19/2012 |
| Last Update Date | 04/25/2013 |
| Medicare PECOS PAC ID | 4587809009 |
|---|---|
| Medicare Enrollment ID | O20130403000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487917993 | NPI | - | NPPES |
| 22D2048592 | Other | MA | CLIA CERTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 77100 (Massachusetts) | Primary |
| Provider Name | John Bordiuk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568571396 PECOS PAC ID: 8729045166 Enrollment ID: I20041216000742 |
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