Individual
MARY BALOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
116 ALLEN DR, ANN ARBOR, MI 48103-4002
(734) 341-0307
Mailing address
116 ALLEN DR, ANN ARBOR, MI 48103-4002
(734) 341-0307
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1087732
MI
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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