Provider Demographics
NPI:1710548722
Name:BALLARD, BRITTANY (PT)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BALLARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2035 CORTE DEL NOGAL STE 200
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1445
Mailing Address - Country:US
Mailing Address - Phone:945-260-0010
Mailing Address - Fax:
Practice Address - Street 1:120 W IDAHO ST STE A
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3939
Practice Address - Country:US
Practice Address - Phone:406-206-4264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-21
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016418225100000X
MT17139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist