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General NPI Number Information
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NPI Number | 1194776294
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Entity Type | Individual
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Provider Name | WALTER DANIEL BALLARD II CERTIFIED PEDORTHIST
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Gender | Male
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 24 PARKWAY COMMONS WAY
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City | GREER
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State | SC
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Zip | 29650-5213
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Country | US
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Telephone | 864-848-3300
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Fax | 864-848-2100
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Provider Business Mailing Address
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Address Line | 24 PARKWAY COMMONS WAY
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City | GREER
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State | SC
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Zip | 29650-5213
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Country | US
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Telephone | 864-848-3300
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Fax | 864-848-2100
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 37
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License Number State | SC
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