Individual
MOLLY BALLEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
295 E MAIN, SUITE 10, ASHLAND, OR 97520-0020
(541) 488-3262
Mailing address
PO BOX 577, ASHLAND, OR 97520-0020
(541) 488-3262
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
BAP-E-541784
OR
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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