Individual
THERESA LEE BALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2540 ONYX DR, SHAKOPEE, MN 55379-2769
(743) 913-1658
Mailing address
23341 ARROWHEAD ST NW, SAINT FRANCIS, MN 55070-9587
(763) 913-1658
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2261025
MN
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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