Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 2924 | OH |
NPI | 1295848612 |
---|---|
Provider Name | Dr. Brian C Ball |
First Address | Parma, OH 44130-1164 |
Second Address | Parma, OH 44130-1164 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 08/07/2007 |