JUSTIN KYLE BALLIET

RIDLEY PARK, PA
NPI1316427651
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: PA  OA004604)
Enumeration Date2018-08-16
Last Update Date2018-10-06
Business Address
JUSTIN KYLE BALLIET PA-C
1 BARTOL AVE STE 14
RIDLEY PARK, PA 19078-2214
Phone number: 610-521-9074
Mailing Address
JUSTIN KYLE BALLIET PA-C
340 MEDIA STATION RD APT C311
MEDIA, PA 19063-4787
Phone number: 570-778-1933
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