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Individual

JOHN LEWIS BALSAMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.T.R

Contact information

Practice address
1 BOONE RD, BREMERTON, WA 98312-1894
(360) 475-5301
Mailing address
100 BREWSTER BLVD, NAVAL HOSPITAL, CAMP LEJEUNE, NC 28547-2538
(910) 450-4159
(910) 450-4194

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
117189
TX
225X00000X
Occupational Therapist
Primary
46TR00339000
NJ

Other

Enumeration date
12/05/2011
Last updated
01/18/2024
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