Individual
SAMUEL BALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
498 PARK AVE, SAN JOSE, CA 95110-2619
(408) 690-7606
Mailing address
498 PARK AVE, SAN JOSE, CA 95110-2619
(408) 690-7606
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
72912
CA
Other
Enumeration date
03/15/2018
Last updated
05/21/2023
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