Balanced Body Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1187252401 Issued in UT

Legal business name

BALANCED BODY PHYSICAL THERAPY

Practice address

4465 S 900 E
Suite 250
Salt Lake City, UT 84124-2456

Phone

(801) 293-8888

Fax

(801) 293-8890

NPI assigned

Aug 11, 2008

Last updated

Feb 18, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dallen B Lovell, PTNPI 1912018110

Title

President

Phone

(801) 293-8888

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dallen Bart Lovell, PT

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1912018110
  NPD Authorized official
• Jane Glaser-Gormally, PT

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1104007947
  NPD (past)
• Tamara L Nichols, MPT

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1942333174
  NPD (past)

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392681600000",
    "number": "1922254903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 S 900 E",
            "address_2": "SUITE 250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242456",
            "telephone_number": "801-293-8888",
            "fax_number": "801-293-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED BODY PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2014-02-18",
        "status": "A",
        "authorized_official_last_name": "LOVELL",
        "authorized_official_first_name": "DALLEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-293-8888",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "1187252401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matte Bakke
• Howard Wiley Bakken
• Rehana Soraya Baksh
• Nehal Kaur Bakshi
• Swathi Balakrishna Kalluraya, MBBS, MD
• Michael Balatico, M.D.
• Heather Balch, M.D.
• Candice Marina Baldeo, MD
• Gabriella Maria Balderrama
• Erin Baldwin, M.S.

• Physical Therapist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; 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.