Individual
HEATHER BALLANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2929 DOUGHERTY FERRY RD, SAINT LOUIS, MO 63122-3318
(636) 825-6665
Mailing address
436 SPRING HILL RD, JACKSON, MO 63755-3122
(573) 270-4595
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2000163573
MO
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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