Individual provider · NPI-1
Reginald E Ballard Jr.
Respiratory Therapist, Certified, Patient Transport · Lansing, IL
NPI number1649785841
StatusActive
Last updated in NPPESOct 18, 2023
Details
- NPI
- 1649785841
- Entity type
- Individual (NPI-1)
- Name
- Mr. Reginald E Ballard Jr.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 10, 2017
- Certification date
- Oct 18, 2023
- Last updated
- Oct 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2278P4000X | Respiratory Therapist, Certified, Patient Transport | – | – | Yes |
Practice location
2305 185th PlLansing, IL 60438
Phone 708-368-0550
Mailing address
2501 Chatham Rd # RSpringfield, IL 62704-4188
Phone 844-727-8883
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