Provider Demographics
NPI:1811026990
Name:BALL, NOAH LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:LEE
Last Name:BALL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1507 MURRAY AVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-4207
Mailing Address - Country:US
Mailing Address - Phone:706-226-2332
Mailing Address - Fax:
Practice Address - Street 1:1507 MURRAY AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-4207
Practice Address - Country:US
Practice Address - Phone:706-226-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR003083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFLZOtherPIN
GAGRP3363OtherGROUP NUMBER
GAGRP3363OtherGROUP NUMBER