Individual
DONALD BALLESTEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1070 CLIFTON AVE, CLIFTON, NJ 07013-3619
(973) 246-6565
Mailing address
1255 ANDERSON AVE, UNIT 10, FORT LEE, NJ 07024-1778
(917) 495-7597
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01048800
NJ
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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