Individual
JOAN BALLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
3482 MAIN, DECKERVILLE, MI 48427-0067
(810) 376-2825
(810) 376-8355
Mailing address
3482 MAIN, PO BOX 67, DECKERVILLE, MI 48427-0067
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21833
MI
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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