| Balance Wellspace Integrative Medicine, Inc. | |
|
2110 Carolina Ave Sw Roanoke VA 24014-1738 | |
| (540) 343-0055 | |
| (540) 343-0056 |
| Full Name | Balance Wellspace Integrative Medicine, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 2110 Carolina Ave Sw, Roanoke, Virginia |
| Authorized Official Name and Position | Jennifer Walker (PRESIDENT) |
| Authorized Official Contact | 5403430055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Balance Wellspace Integrative Medicine, Inc. 2110 Carolina Ave Sw Roanoke VA 24014-1738 Ph: (540) 343-0055 | Balance Wellspace Integrative Medicine, Inc. 2110 Carolina Ave Sw Roanoke VA 24014-1738 Ph: (540) 343-0055 |
| NPI Number | 1164966446 |
|---|---|
| Provider Enumeration Date | 12/06/2016 |
| Last Update Date | 12/06/2016 |
| Medicare PECOS PAC ID | 9638410624 |
|---|---|
| Medicare Enrollment ID | O20190329002251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164966446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Ann Marie Harman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194728980 PECOS PAC ID: 6901854942 Enrollment ID: I20050224000958 |
| Provider Name | Jennifer E Walker |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1649200130 PECOS PAC ID: 0749296846 Enrollment ID: I20060227000691 |
| Provider Name | Lori Rutherford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679538946 PECOS PAC ID: 6002055548 Enrollment ID: I20170418002358 |
| Provider Name | Sharon Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831627512 PECOS PAC ID: 9830454867 Enrollment ID: I20180522003058 |
| Provider Name | Rachel L Evans |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1225534365 PECOS PAC ID: 6901152461 Enrollment ID: I20180713000879 |
| Provider Name | Robin Patience Akers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154800209 PECOS PAC ID: 6800137803 Enrollment ID: I20190329002383 |
| Provider Name | Justin Keith Ginnings |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1932837978 PECOS PAC ID: 0345614251 Enrollment ID: I20230316000153 |
| Provider Name | Elizabeth Marie Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487359741 PECOS PAC ID: 3971957648 Enrollment ID: I20230928002883 |
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