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General NPI Number Information
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NPI Number | 1538262126
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Entity Type | Organization
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Legal Business Name | SCOTT T. BALLARD D.C. LLC
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 02/07/2011
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Provider Practice Location Address
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Address Line | 2478 PASS RD
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City | BILOXI
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State | MS
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Zip | 39531
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Country | US
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Telephone | 228-388-5753
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Fax | 228-594-1717
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Provider Business Mailing Address
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Address Line | PO BOX 4441 2478 PASS RD
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City | BILOXI
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State | MS
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Zip | 39531
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Country | US
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Telephone | 228-388-5753
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Fax | 228-594-1717
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT T. BALLARD
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Credential | D.C.
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Telephone | 228-388-5753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0466
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1123
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License Number State | MS
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