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Individual
DR. NATHANIEL ROY BALLAM
Active
Individual
DR. NATHANIEL ROY BALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0021737
CO
183500000X
Pharmacist
Primary
7430082
UT
183500000X
Pharmacist
P8372
ID
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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