Individual
JUSTIN B BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3347 S STATE ROAD 7 STE 101, WELLINGTON, FL 33449-8148
(561) 790-2111
(561) 296-0436
Mailing address
2160 COLONIAL BLVD, FORT MYERS, FL 33907-1410
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106475
FL
Other
Enumeration date
03/30/2012
Last updated
12/12/2017
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