Michael J. Ballard, MS ATC, PES

Individual provider Active NPI Athletic Trainer · Clover, SC

NPI 1093937401 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1093937401
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
181 (SC)
Practice address
1625 Highway 55 E
Clover, SC 29710-8551
Phone
(803) 222-4591
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
181SCMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 181 SC Yes

Addresses

Primary practice location

1625 Highway 55 E
Clover, SC 29710-8551

Mailing address

1405 Whirlaway CT
York, SC 29745-6700
Phone (803) 684-7850

Other providers in Clover, SC

All providers in Clover, SC · Athletic Trainer in South Carolina

Sources for this page

Verify at the official NPI Registry.