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Individual

MR. STEVEN RILEY BALLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
A.B.O.C.

Contact information

Practice address
73885 HIGHWAY 111, SUITE 9, PALM DESERT, CA 92260-4027
(303) 244-9900
Mailing address
73885 HIGHWAY 111, SUITE 9, PALM DESERT, CA 92260-4027
(303) 919-2303

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
160688
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
160688
AMERICAN BOARD OF OPTICIANS
CA
Enumeration date
09/15/2010
Last updated
07/25/2011
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