Most Relevant Information
Provider Data
| NPI Number: | 1003351412 |
| Provider Name: | IVAN L BALLARD CDCA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/21/2016 |
| Last Updated: | 12/21/2016 |
Provider Practice Location
311 E MARKET ST
LIMA
OH
458014535
Practice Location Phone/Fax
| Phone: | 4192224474 |
| Fax: |
Provider Mailing Location
311 E MARKET ST
LIMA
OH
458014535
Provider Mailing Phone/Fax
| Phone: | 4192224474 |
| Fax: |