Individual
RACHEL ELISE BALLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM, AACFAS
Contact information
Practice address
100 SIMSBURY RD STE 209, AVON, CT 06001-3793
(860) 674-0284
Mailing address
100 SIMSBURY STE 209, AVON, CT 06001-3793
(860) 674-0284
(860) 674-0292
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000850
CT
213ES0103X
Foot & Ankle Surgery Podiatrist
25MD00297200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MD00297200
LICENSE
NJ
Enumeration date
07/10/2008
Last updated
11/02/2020
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