Individual
LISA MARIE BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
10600 MASTIN ST, OVERLAND PARK, KS 66212-5723
(913) 681-0606
(913) 338-1311
Mailing address
PO BOX 741331, ATLANTA, GA 30374-1331
(913) 469-0503
(913) 428-1500
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-04891
KS
225100000X
Physical Therapist
PT 35887
CA
225100000X
Physical Therapist
PT60342038
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538390984
—
WA
Enumeration date
08/03/2009
Last updated
09/10/2014
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