Individual
JACKSON OLDHAM BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
487 LAKE CONCORD RD NE, CONCORD, NC 28025-2934
(704) 403-0200
Mailing address
6419 CEDAR CROFT DR, CHARLOTTE, NC 28270-0301
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P23015
NC
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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