Most Relevant Information
Provider Data
| NPI Number: | 1003019795 |
| Provider Name: | ANGELA TIANA BALLEW D.C. |
| Entity Type: | Individual |
| Taxonomy Code: | 111N00000X |
| Specialty: | Chiropractor |
| License Number: | 006980 |
Most Important Dates
| Enumeration Date: | 06/08/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2711 W 63RD ST
SUITE 4
DAVENPORT
IA
52803
Practice Location Phone/Fax
| Phone: | 5633591455 |
| Fax: | 5633591498 |
Provider Mailing Location
2711 W 63RD ST
SUITE 4
DAVENPORT
IA
52803
Provider Mailing Phone/Fax
| Phone: | 5633591455 |
| Fax: | 5633591498 |