Individual
MRS. TONIKA M BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4165 CLARKS TRL, DOUGLASVILLE, GA 30135-8686
(404) 484-5261
Mailing address
4165 CLARKS TRL, DOUGLASVILLE, GA 30135-8686
(404) 484-5261
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
041990117
GA
172A00000X
Driver
04199017
GA
172A00000X
Driver
—
—
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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