Organization
RICHARD D BALLARD DC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD BALLARD DC (OWNER)
(423) 283-9683
Entity
Organization
Contact information
Practice address
1102 SUNSET DR, JOHNSON CITY, TN 37604-3673
(423) 283-9683
(423) 283-9685
Mailing address
PO BOX 4656, JOHNSON CITY, TN 37602-4656
(423) 283-9683
(423) 283-9685
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1859
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033143938
CIGNA PROVIDER ID
TN
01
—
4050652
BCBSTN
TN
01
—
5756110001
DME SUPPLIER ID
TN
Enumeration date
03/22/2007
Last updated
08/22/2020
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