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1184600405
BRYAN LEE BACON
APO, AE
NPI
1184600405
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: HI DOS917)
Enumeration Date
2005-12-19
Last Update Date
2022-09-30
Business Address
BRYAN LEE BACON DO
CMR 459 BOX 2403
APO, AE 09139
Phone number: 314-469-7775
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Mailing Address
BRYAN LEE BACON DO
CMR 459 BOX 2403
APO, AE 09139
Phone number:
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