BRUCE ALLEN BALLOU

LAWTON, OK
NPI1982831186
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2009-06-15
Last Update Date2009-06-15
Business Address
-- BRUCE ALLEN BALLOU BS
1202 SW A AVE
LAWTON, OK 73501-3821
Phone number: 580-357-8114
Mailing Address
-- BRUCE ALLEN BALLOU BS
1202 SW A AVE
LAWTON, OK 73501-3821
Phone number: 580-357-8114
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