Individual
SHANNON BALLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1470 400 W, SALT LAKE CITY, UT 84115
(206) 930-8971
Mailing address
2991 S ELGIN HILL CT # 8, MILLCREEK, UT 84106-4549
(206) 930-8971
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
11803306-2401
UT
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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