Individual
JORDAN MARIE BALLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2495 OLD TAYLOR RD UNIT 107, OXFORD, MS 38655-5181
(252) 241-9690
Mailing address
2495 OLD TAYLOR RD UNIT 107, OXFORD, MS 38655-5181
(252) 241-9690
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
24993
NC
Other
Enumeration date
06/27/2015
Last updated
07/05/2019
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