Provider Demographics
NPI:1285375154
Name:BALL, JAIME MARIE (DPT)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:MARIE
Last Name:BALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 ASHLAND ST STE 204
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1971
Mailing Address - Country:US
Mailing Address - Phone:541-482-0242
Mailing Address - Fax:
Practice Address - Street 1:2205 ASHLAND ST STE 204
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1971
Practice Address - Country:US
Practice Address - Phone:541-482-0242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist