Individual provider · NPI-1

Jeremy Ballard

Specialist/Technologist, Other, Surgical Technologist · Scottsdale, AZ

NPI number1366989477

StatusActive

Last updated in NPPESJan 26, 2017

Details

NPI: 1366989477
Entity type: Individual (NPI-1)
Name: Jeremy Ballard
Sex: Male
Sole proprietor: No
Enumeration date: Jan 26, 2017
Last updated: Jan 26, 2017

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
246ZS0410X	Specialist/Technologist, Other, Surgical Technologist	–	–	Yes

Practice location

7025 N Scottsdale Rd
Suite #302
Scottsdale, AZ 85253-3675

Phone 480-657-6007 · Fax 480-657-7020

Mailing address

7025 N Scottsdale Rd
Suite #302
Scottsdale, AZ 85253-3675

Phone 480-657-6007 · Fax 480-657-7020

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