Individual
JACOB E BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
464 SAINT LUKES DR, MONTGOMERY, AL 36117-7104
(334) 272-0853
(334) 272-0871
Mailing address
464 SAINT LUKES DR, MONTGOMERY, AL 36117-7104
(334) 272-0853
(334) 272-0871
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1049
AL
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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