Individual
AARON M BALLENSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
390 N RIVER DR, ROSEBURG, OR 97470-8008
(541) 743-5445
Mailing address
390 N RIVER DR, ROSEBURG, OR 97470-8008
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PI-0010645
OR
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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