Trisha M Ballard
Individual provider Active NPI Physical Therapy Assistant · Niles, MI
NPI 1659839280 · NPPES record last updated Mar 2, 2019
Key facts
- NPI
- 1659839280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 5502002650 (MI)
- Practice address
- 911 S 3Rd St
Niles, MI 49120-3414 - Phone
- (269) 684-4320
- NPI assigned
- Mar 2, 2019
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5502002650 | MI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5502002650 | MI | Yes |
Addresses
Primary practice location
911 S 3Rd St
Niles, MI 49120-3414
Mailing address
243 Bond St
Niles, MI 49120-3245
Phone (269) 362-7977
Other providers in Niles, MI
- Authentic Life Center LLC
- Denise Audrey Ayo
- Jayssie Badette
- Lisa Ann Bailey
- Sarah Ann Bailey
- Richard L Bardin
- Kelsey Barkman
- Gregory Arnell Barney
- Jacquelyn Barney
- James W. Bateman
All providers in Niles, MI · Physical Therapy Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.