Basic Information
| Provider Information | |||||||||
| NPI: | 1295223964 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BALLONE | ||||||||
| FirstName: | JOELLE | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5500 NEW CASTLE RD | ||||||||
| Address2: | |||||||||
| City: | LOWELLVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444369416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303509391 | ||||||||
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| Practice Location | |||||||||
| Address1: | MERCY GANDY OUTPATIENT OFFICE | ||||||||
| Address2: | 2200 JEFFERSON AVENUE | ||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436042603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192511400 | ||||||||
| FaxNumber: | 4192514159 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2018 | ||||||||
| LastUpdateDate: | 04/27/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.