Individual
CHARLES W BALLARD II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8500 NW 112TH TER, OKLAHOMA CITY, OK 73162-2131
(316) 390-9673
Mailing address
8500 NW 112TH TER, OKLAHOMA CITY, OK 73162-2131
(316) 390-9673
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/07/2019
Last updated
01/07/2019
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