Balance and Fall Prevention Clinic, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT001749E Issued in PA

Legal business name

BALANCE AND FALL PREVENTION CLINIC, INC

Practice address

173 S Market St
Elysburg, PA 17824-9757

Phone

(570) 672-2277

NPI assigned

Jan 13, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary Theresa Stout, PT,DPT

Title

Ceo/Therapist

Phone

(570) 672-2277

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1154692747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 S MARKET ST",
            "city": "ELYSBURG",
            "state": "PA",
            "postal_code": "178249757",
            "telephone_number": "570-672-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 S MARKET ST",
            "city": "ELYSBURG",
            "state": "PA",
            "postal_code": "178249757",
            "telephone_number": "570-672-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCE AND FALL PREVENTION CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "THERESA",
        "authorized_official_title_or_position": "CEO/THERAPIST",
        "authorized_official_telephone_number": "570-672-2277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT,DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": "PT001749E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "412246",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda M. Hummel
• Elizabeth Aten, PTA
• Linda Ayres, RPH
• Fran Bakich, LMT, MMP
• Rebekah Billig, RPH
• Bloomsburg Physicians Services
• Francis B Bobek, MD
• Boltinghouse Corporation
• Karen Kaye Boltinghouse, RPH

• Physical Therapy Clinic/Center in Elysburg, PA
• Providers in Elysburg, PA by specialty
• Physical Therapy Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.