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1982831186
BRUCE ALLEN BALLOU
LAWTON, OK
NPI
1982831186
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2009-06-15
Last Update Date
2009-06-15
Business Address
-- BRUCE ALLEN BALLOU BS
1202 SW A AVE
LAWTON, OK 73501-3821
Phone number: 580-357-8114
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Mailing Address
-- BRUCE ALLEN BALLOU BS
1202 SW A AVE
LAWTON, OK 73501-3821
Phone number: 580-357-8114
Copy
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