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Individual

MR. PERRY BALCOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
22510 SE 64TH PL STE 110, ISSAQUAH, WA 98027-5389
(406) 471-1055
Mailing address
22510 SE 64TH PL STE 110, ISSAQUAH, WA 98027-5389
(406) 471-1055

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN 60188130
WA

Other

Enumeration date
01/15/2013
Last updated
01/15/2013
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