BRENT MICHAEL BURNHAM

SHREVEPORT, LA
NPI1407256050
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: LA  08035)
Enumeration Date2014-09-02
Last Update Date2014-09-02
Business Address
-- BRENT MICHAEL BURNHAM
273 SAWGRASS DR
SHREVEPORT, LA 71106-8413
Phone number: 318-464-2288
Mailing Address
-- BRENT MICHAEL BURNHAM
273 SAWGRASS DR
SHREVEPORT, LA 71106-8413
Phone number:
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