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1366062291
JAMES BROOK BALLOCH
FARMINGTON, CT
NPI
1366062291
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: CT 12867)
Enumeration Date
2020-04-21
Last Update Date
2020-08-05
Business Address
JAMES BROOK BALLOCH
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 860-679-2000
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Mailing Address
JAMES BROOK BALLOCH
25 KAREN DR
PORTLAND, CT 06480-1016
Phone number:
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