Provider Demographics
NPI:1306689690
Name:BALL, JAROD RANDALL (DPT)
Entity type:Individual
Prefix:
First Name:JAROD
Middle Name:RANDALL
Last Name:BALL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PETERS CANYON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1798
Mailing Address - Country:US
Mailing Address - Phone:949-679-3988
Mailing Address - Fax:949-679-7665
Practice Address - Street 1:2943 S CHURCH ST STE D
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37127-6550
Practice Address - Country:US
Practice Address - Phone:615-962-8232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist