Individual
KATHLEEN MARIE BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 774-2381
(207) 774-0459
Mailing address
887 CONGRESS ST STE 400, PORTLAND, ME 04102-3163
(207) 774-6368
(207) 662-7996
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1494
ME
Other
Enumeration date
06/29/2014
Last updated
11/08/2023
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