Individual
MICHAEL F BALLARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
5722 INTEGRITY DR, BLDG S771, MILLINGTON, TN 38054-5028
(901) 874-6100
Mailing address
7698 KIOWA ST, MILLINGTON, TN 38053-3248
(901) 872-7848
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
01/23/2006
Last updated
07/08/2007
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