MICHAEL ROBERT BALLASCH

PHOENIX, AZ
NPI1811401169
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: AZ  1644)
Enumeration Date2017-11-24
Last Update Date2017-11-24
Business Address
MICHAEL ROBERT BALLASCH AT
1202 W THOMAS RD
PHOENIX, AZ 85013-4208
Phone number: 602-285-7239
Mailing Address
MICHAEL ROBERT BALLASCH AT
1202 W THOMAS RD
PHOENIX, AZ 85013-4208
Phone number:
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