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1548997562
TANJA LEE BALLANCE
ROCK SPRINGS, WY
NPI
1548997562
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X
Enumeration Date
2022-08-01
Last Update Date
2022-08-01
Business Address
TANJA LEE BALLANCE
1040 MAPLE WAY
ROCK SPRINGS, WY 82901-4108
Phone number: 307-389-0784
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Mailing Address
TANJA LEE BALLANCE
1040 MAPLE WAY
ROCK SPRINGS, WY 82901-4108
Phone number: 307-389-0784
Copy
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