Individual
DR. SALLY CARABALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
55 N CENTRAL AVE, SUITE 3, FAIRBORN, OH 45324-5087
(937) 878-2800
(937) 878-7261
Mailing address
55 N CENTRAL AVE, SUITE 3, FAIRBORN, OH 45324-5087
(937) 878-2800
(937) 878-7261
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
2815
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0173726
—
OH
Enumeration date
08/18/2005
Last updated
07/08/2007
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