CHRISTOPHER BLAKE BAMBURG

MONROE, LA
NPI1780994277
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: LA  PA200394)
Enumeration Date2010-10-18
Last Update Date2019-06-11
Business Address
CHRISTOPHER BLAKE BAMBURG pa
920 OLIVER RD
MONROE, LA 71201-5702
Phone number: 318-807-6267
Mailing Address
CHRISTOPHER BLAKE BAMBURG pa
130 DESIARD ST STE 355
MONROE, LA 71201-7363
Phone number: 318-807-7875