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1558793653
ANGELA DAWN BALLOU
SAN JOSE, CA
NPI
1558793653
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174400000X Specialist
(Licence: CA 5802)
Enumeration Date
2013-07-31
Last Update Date
2013-07-31
Business Address
-- ANGELA DAWN BALLOU OTR/L
1052 DELNA MANOR LN
SAN JOSE, CA 95128-3457
Phone number: 408-722-8629
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Mailing Address
-- ANGELA DAWN BALLOU OTR/L
PO BOX 8633
SAN JOSE, CA 95155-8633
Phone number: 408-722-8629
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