Individual
SAMUEL RYAN BALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 S TILLOTSON AVE, MUNCIE, IN 47304-4356
(765) 287-0074
Mailing address
201 S TILLOTSON AVE, MUNCIE, IN 47304-4356
(765) 287-0074
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26021154A
IN
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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