Individual
TONY GORDON BALLENSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
435 S CRYSTAL ST STE 300, BUTTE, MT 59701-1506
(406) 496-3600
Mailing address
3204 PHILLIPS ST, BUTTE, MT 59701-4526
(406) 490-0756
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
128284
MT
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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