Individual
MR. MARSHALL BALLOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, TAMC, HI 96859-5001
(808) 433-2998
Mailing address
PO BOX 10886, HONOLULU, HI 96816-0886
(808) 433-2998
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
101333
MA
Other
Enumeration date
07/16/2006
Last updated
07/08/2007
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