Individual
KRYSTAL SUZANNE BALLOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHP
Contact information
Practice address
#3 ADAMS LANDING-OLD, SELAWIK, AK 99770-0180
(907) 484-2199
(907) 484-2119
Mailing address
#3 ADAMS LANDING-OLD, BOX 180, SELAWIK, AK 99770-0180
(907) 484-2199
(907) 484-2119
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
00-378-P
AK
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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