BLAKE A. BALLARD

MONTICELLO, MS
NPI1487255535
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: MS  PTA6757)
Enumeration Date2020-11-05
Last Update Date2020-11-05
Business Address
BLAKE A. BALLARD PTA
314 MAIN ST STE C
MONTICELLO, MS 39654-3702
Phone number: 601-587-2563
Mailing Address
BLAKE A. BALLARD PTA
PO BOX 457
MONTICELLO, MS 39654-0457
Phone number: 601-587-2563
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