BRYAN LEE BACON

APO, AE
NPI1184600405
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: HI  DOS917)
Enumeration Date2005-12-19
Last Update Date2022-09-30
Business Address
BRYAN LEE BACON DO
CMR 459 BOX 2403
APO, AE 09139
Phone number: 314-469-7775
Mailing Address
BRYAN LEE BACON DO
CMR 459 BOX 2403
APO, AE 09139
Phone number: