Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Michael Robert Ballasch, AT

Individual provider Athletic Trainer · NPI 1811401169

Michael Robert Ballasch, AT is an Athletic Trainer in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2017.

Licensed in
AZ
In the registry since
2017

Practice location Address checks out

1202 W Thomas Rd
Phoenix, AZ 85013-4208
Phone: (602) 285-7239
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 1644 (AZ)

Record details

NPI number1811401169
Entity typeIndividual (Type 1)
GenderMale
Credentials AT
Sole proprietorNo
NPI enumeratedNovember 24, 2017
Last updated in NPPESNovember 24, 2017
Mailing address1202 W Thomas Rd, Phoenix, AZ 85013-4208

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