NPI 1043146269

Leaf Aquilla Ballast

Practitioner Military Health Care Provider Mandeville, LA

Practice location

Address: 810 Rapatel St, Mandeville, LA 70448-5528
Phone: (850) 736-3840

Registered specialties

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X

Other Military Health Care Provider providers in Louisiana →

Registry record

NPI: 1043146269
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jun 2026
Record last updated: 23 Jun 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.