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1811401169
MICHAEL ROBERT BALLASCH
PHOENIX, AZ
NPI
1811401169
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: AZ 1644)
Enumeration Date
2017-11-24
Last Update Date
2017-11-24
Business Address
MICHAEL ROBERT BALLASCH AT
1202 W THOMAS RD
PHOENIX, AZ 85013-4208
Phone number: 602-285-7239
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Mailing Address
MICHAEL ROBERT BALLASCH AT
1202 W THOMAS RD
PHOENIX, AZ 85013-4208
Phone number:
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