Individual
JESSICA BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
17823 POPLAR GROVE RD, POPLAR GROVE, IL 61065-9014
(815) 765-3311
Mailing address
8369 DELTA DR APT 4, MACHESNEY PARK, IL 61115-4443
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004283
IL
Other
Enumeration date
12/18/2019
Last updated
12/18/2019
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