KEITH E. BALLINGER

MATTOON, IL
NPI1114934759
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208800000X Urology
(Licence: IL  085001872)
Additional Taxonomies363A00000X Physician Assistant
(Licence: IL  085001872)
Enumeration Date2006-08-02
Last Update Date2024-10-22
Business Address
Mr. KEITH E. BALLINGER PA C
1000 HEALTH CENTER DR STE 305
MATTOON, IL 61938-4644
Phone number: 217-258-4186
Mailing Address
Mr. KEITH E. BALLINGER PA C
PO BOX 372
MATTOON, IL 61938-0372
Phone number: