Individual
DR. WALTER ERNEST BALFOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
219 W COAL AVE, GALLUP, NM 87301-6305
(505) 863-6448
(505) 722-6491
Mailing address
219 W COAL AVE, GALLUP, NM 87301-6305
(505) 863-6448
(505) 722-6491
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
240
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P-2736
—
NM
Enumeration date
01/01/2007
Last updated
07/08/2007
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