MR. BRIAN BOURBON, CERTIFIED PEDORTHIST
Specialist
Active
Individual
NPI: 1790124923
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Specialist | 174400000X | Yes | CPED3999 (MO) |
Frequently Asked Questions
NPI 1790124923 is the National Provider Identifier for MR. BRIAN BOURBON, CERTIFIED PEDORTHIST, a Specialist provider located in Creve Coeur, MO. This NPI was enumerated on June 20, 2013.
MR. BRIAN BOURBON, CERTIFIED PEDORTHIST practices at 11709 OLD BALLAS RD, SUITE 201, Creve Coeur, MO 63141.
Quick Facts
- NPI
- 1790124923
- Type
- Individual
- Enumerated
- Jun 20, 2013
- Last Updated
- Jun 20, 2013
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