Individual
KIMANDA BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9102 N GARNETT RD, OWASSO, OK 74055-4470
(918) 516-2524
Mailing address
16560 RANCHLAND RD, SKIATOOK, OK 74070-6001
(918) 500-6245
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
152638
OK
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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