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MICHAEL RAY BALLANCE PT

Pediatrics >> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1205400983

Individual Registrant:
 MICHAEL RAY BALLANCE PT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
825 W LOCKEFORD ST  LODI, CA 95240-1633 US
Tel: 209-331-7471  Fax: 209-331-7464

Contact information for business:
12270 KIRKWOOD ST  HERALD, CA 95638-9765 US
Tel: 209-663-8013  Fax: --

Registration Information:
NPI: 1205400983
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
Pediatrics
CAPT18492

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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