Lifestyle Balance Healthcare Trust

NPI #1972701688 in Mesa, Arizona

Provider Information

NPI Number: 1972701688
Entity Type: Organization
Organization Name: Lifestyle Balance Healthcare Trust
Primary Specialty: Chiropractor
Enumeration Date: Jul 3, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 65 E 1ST AVE STE 101
City: Mesa
State: Arizona
ZIP Code: 85210-1456
Phone: (480) 962-4649

Authorized Official

Name: DR. LARRY ROSS JOHNSTON, D.C.
Title: ACTING CHIEF EXECUTIVE OFFICER
Phone: (480) 962-4649

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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