Individual
MS. ANTIONETTE BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QDDP
Contact information
Practice address
1216 E LITTLE CREEK RD, SUITE 303, NORFOLK, VA 23518-3900
(757) 289-5946
(757) 480-0528
Mailing address
1216 E LITTLE CREEK RD, SUITE 303, NORFOLK, VA 23518-3900
(757) 289-5946
(757) 480-0528
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/30/2006
Last updated
07/09/2007
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