Individual
MR. BALAKUMAR PERIYASAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 GILES ST, OMAHA, TX 75571-4013
(703) 880-6448
Mailing address
43997 RIVERPOINT DR, LEESBURG, VA 20176-8202
(202) 487-8221
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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