Individual
MR. BRUCE SPENCER BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 605-8869
Mailing address
1202 HARRISON ST, TUPELO, MS 38801-5646
(662) 680-9416
(662) 862-4970
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2771
MS
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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