Ball, Burley Walter

Ball, Burley Walter is an sole proprietor health care provider with primary practice located at 4313 Buckingham Rd , Coeburn VA 24230. He recently has only one registered license in Other Service Providers / Driver, which is considered as his primary health care specialty. Ball, Burley Walter can be contacted via phone (276) 395-1323.

Contact Information

Primary practice address
4313 Buckingham Rd Coeburn VA 24230
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X T64011149 Virginia

Profile Details

NPI number 1285240523
LBN Legal business name Ball, Burley Walter
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 22nd, 2020
Last updated Sep 22nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285240523 NPPES
Virginia MEDICAID T64011149

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