Individual
MICHAEL BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRS
Contact information
Practice address
206 S ORANGE ST, MEDIA, PA 19063-3679
(855) 687-2410
Mailing address
206 S ORANGE ST, MEDIA, PA 19063-3679
(855) 687-2410
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CRS
PA
Other
Enumeration date
12/10/2021
Last updated
12/10/2021
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