Individual
PHILIP ANDERS BALLANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
915 W EMMA AVE, COEUR D ALENE, ID 83814-2531
(208) 665-1700
(208) 667-8649
Mailing address
915 W EMMA AVE, COEUR D ALENE, ID 83814-2531
(208) 665-1700
(208) 667-8649
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
5974
MT
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
5974
MT
Other
Enumeration date
12/04/2009
Last updated
10/04/2022
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