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Individual

ERIC RAYMOND BALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
175 N TORNADO DIVISION RD BLDG 2866, FORT KNOX, KY 40121-4218
(502) 624-1208
Mailing address
102 FEDERAL PL, BARDSTOWN, KY 40004-2046
(765) 490-8144

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003298
GA

Other

Enumeration date
03/22/2022
Last updated
03/22/2022
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