Individual
CRYSTAL LYNN BALLENGEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
300 SEVILLE RD, HURRICANE, WV 25526-9206
(304) 757-6805
Mailing address
207 BEECHWOOD EST, SCOTT DEPOT, WV 25560-9724
(304) 206-6857
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1329
WV
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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