Individual
CODY BALLANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
337 75TH AVE, ST PETE BEACH, FL 33706-1829
(727) 367-7657
Mailing address
100 4TH AVE S APT 228, ST PETERSBURG, FL 33701-4370
(727) 465-6699
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS 46832
FL
Other
Enumeration date
02/04/2012
Last updated
02/04/2012
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