MIRANDA BALLARD

MERIDIAN, ID
NPI1568711893
Former NameMIRANDA JOHNSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  PT-3012)
Enumeration Date2012-08-31
Last Update Date2020-06-04
Business Address
MIRANDA BALLARD PT, DPT
179 SW 5TH AVENUE
MERIDIAN, ID 83642
Phone number: 208-367-8282
Mailing Address
MIRANDA BALLARD PT, DPT
179 SW 5TH AVENUE
MERIDIAN, ID 83642
Phone number: 208-367-8282
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