Individual
MR. BRIAN THOMAS BALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.F.A.
Contact information
Practice address
760 E WASHINGTON ST, MONTICELLO, FL 32344-2549
(850) 997-4400
Mailing address
356 LUTHER FOUNTAIN RD, MONTICELLO, FL 32344-4962
(850) 509-0463
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
OFA 160
FL
225000000X
Orthotic Fitter
Primary
ORF 168
FL
Other
Enumeration date
06/23/2006
Last updated
09/11/2008
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