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Individual

CHRISTOPHER WAYNE BALLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
7345 S 99TH EAST AVE, TULSA, OK 74133-1001
(918) 551-9987
Mailing address
6780 E 124TH ST S, BIXBY, OK 74008-3569
(918) 551-9987

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1739
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NA
NA
Enumeration date
07/20/2020
Last updated
07/20/2020
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