Individual
ZACHARY BALLEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-4750
Mailing address
9134 HERITAGE DR APT D, SAINT LOUIS, MO 63123-4153
(314) 221-7292
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2022030314
MO
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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