Individual
WILBUR BALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
LAWTEY CORRECTIONAL INSTITUTION, 7819 NW 228 ST., RAIFORD, FL 32026-0001
(904) 782-2318
(904) 782-2011
Mailing address
LAWTEY CORRECTIONAL INSTITUTION, 7819 NW 228 ST., RAIFORD, FL 32026
(904) 782-2318
(904) 782-2011
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME27246
FL
Other
Enumeration date
11/25/2013
Last updated
11/25/2013
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