Individual
MICHEL GBALLOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11255 LOGENBERRY CIR, CINCINNATI, OH 45240-2328
(513) 487-9743
Mailing address
11255 LOGENBERRY CIR, CINCINNATI, OH 45240-2328
(513) 487-9743
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
TF483259
OH
Other
Enumeration date
05/17/2020
Last updated
05/17/2020
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