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1366022766
MATTHEW BALLARD
GLENDALE, AZ
NPI
1366022766
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-09
Last Update Date
2021-05-17
Business Address
MATTHEW BALLARD
18701 N 67TH AVE
GLENDALE, AZ 85308-7100
Phone number: 503-580-1898
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Mailing Address
MATTHEW BALLARD
1937 N 1640 W
PROVO, UT 84604-5626
Phone number: 503-580-1898
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