Randall Ballard
Technician, Other in Atlanta, GA. Individual provider (NPI-1).
NPI number1356880025
StatusActive
Last updated in NPPESFeb 14, 2017
Details
- NPI
- 1356880025
- Entity type
- Individual (NPI-1)
- Name
- Mr. Randall Ballard
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 14, 2017
- Last updated
- Feb 14, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
935 Marietta St Nw29
Atlanta, GA 30318-0527
Phone 678-663-8714
Mailing address
935 Marietta St Nw29
Atlanta, GA 30318-0527
Phone 678-663-8714
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