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Individual

CLEO J BALLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3314 N HIGHWAY 52, SAINT STEPHEN, SC 29479-3322
(678) 543-4006
Mailing address
3314 N HIGHWAY 52, SAINT STEPHEN, SC 29479-3322
(678) 543-4006

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
007568645
SC

Other

Enumeration date
06/29/2022
Last updated
06/29/2022
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