NPI 1205568029

Cleo J Ballard

Practitioner Driver Saint Stephen, SC

Practice location

Address: 3314 N Highway 52, Saint Stephen, SC 29479-3322
Phone: (678) 543-4006

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 007568645 (SC)

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Registry record

NPI: 1205568029
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 Jun 2022
Record last updated: 29 Jun 2022

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.