Individual
MRS. LORA BALLENGEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
75 SYLVANIA DR, DAYTON, OH 45440-3237
(937) 320-5050
(937) 320-5060
Mailing address
PO BOX 381468, GERMANTOWN, TN 38183-1468
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.009136RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0103848
—
OH
Enumeration date
09/12/2022
Last updated
02/09/2026
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