Individual
MR. STACY ANNE BALL-DERNOSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3590 WASHINGTON PIKE, BRIDGEVILLE, PA 15017-1047
(412) 257-2474
Mailing address
856 WHEATLAND CIR, BRIDGEVILLE, PA 15017-1123
(724) 207-0052
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE008478
PA
Other
Enumeration date
05/20/2010
Last updated
05/20/2010
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