MR. Randy Allan Ballard, ATC

NPI #1710375712 in Champaign, Illinois

Provider Information

NPI Number
1710375712
Entity Type
Individual
Name
MR. Randy Allan Ballard, ATC
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Specialist/Technologist - Athletic Trainer
Credential
ATC
Enumeration Date
Dec 30, 2014
Last Updated
Dec 30, 2014

Practice Location

Address
3112 VALERIE DR
ZIP Code
61822-1831
Phone
(217) 766-8137

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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