Individual
JACQUELYN N BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
324 W 5TH ST, WASHINGTON, MO 63090-2306
(636) 239-7848
Mailing address
324 W 5TH ST, WASHINGTON, MO 63090-2306
(636) 239-7848
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2009019552
MO
225100000X
Physical Therapist
PT25053
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT25053
LICENSE NUMBER
FL
Enumeration date
12/17/2009
Last updated
05/26/2011
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