Mr. Brian Douglass Bourbon, CERTIFIEDPEDORTHIST
Mr. Brian Douglass Bourbon, CERTIFIEDPEDORTHIST is a Specialist in Creve Coeur, Missouri. Licensed in Missouri. Registered with an NPI since 2013.
- Licensed in
- MO
- In the registry since
- 2013
Practice location Address checks out
11709 Old Ballas Rd Ste 201Creve Coeur, MO 63141-7029
Phone: (314) 432-1903
Fax: (314) 432-5105
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Specialist (primary) | Taxonomy 174400000X · Licence CPED3999 (MO) |
|---|
Record details
| NPI number | 1790124923 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | CERTIFIEDPEDORTHIST |
| Sole proprietor | No |
| NPI enumerated | June 20, 2013 |
| Last updated in NPPES | June 20, 2013 |
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-
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-
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