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Organization
AETERNUM FORTIS MEDICAL PLLC
Active
Organization
AETERNUM FORTIS MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON E BALLARD DC (MANAGING MANAGER)
(210) 364-3569
Entity
Organization
Contact information
Practice address
7180 BANDERA RD, SAN ANTONIO, TX 78238-1295
(210) 521-6886
(210) 521-6608
Mailing address
7180 BANDERA RD, SAN ANTONIO, TX 78238-1295
(210) 521-6886
(210) 521-6608
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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