Provider Demographics
NPI:1255722757
Name:BALLINGER, VANESSA (RPH)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:BALLINGER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15031 E STATE ROUTE 224
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-7764
Mailing Address - Country:US
Mailing Address - Phone:419-420-0084
Mailing Address - Fax:
Practice Address - Street 1:15031 E STATE ROUTE 224
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-7764
Practice Address - Country:US
Practice Address - Phone:419-420-0084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist