Healthcare Provider Details

I. General information

NPI: 1740745637
Provider Name (Legal Business Name): SAVANNAH CLAIRE MORGAN BALLARD PT, DPT, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2019
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 MCQUEEN SMITH RD N STE H
PRATTVILLE AL
36066-7559
US

IV. Provider business mailing address

16395 MCKENZIE GRADE
GEORGIANA AL
36033-5822
US

V. Phone/Fax

Practice location:
  • Phone: 334-350-3362
  • Fax:
Mailing address:
  • Phone: 334-429-2188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH11957
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: