Individual
GARRETT CLYDE BALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MILITARY PROVIDER
Contact information
Practice address
116 MOSS CREEK DR, JACKSONVILLE, NC 28540-3231
(805) 305-1868
Mailing address
610 LOOP RD, SNEADS FERRY, NC 28460
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/26/2021
Last updated
11/09/2021
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