Individual
MR. RYAN JAMES BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 364-9000
Mailing address
11528 PINE FOREST DR, ROLLA, MO 65401-5427
(509) 855-2116
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2019011200
MO
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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