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1780994277
CHRISTOPHER BLAKE BAMBURG
MONROE, LA
NPI
1780994277
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA PA200394)
Enumeration Date
2010-10-18
Last Update Date
2019-06-11
Business Address
CHRISTOPHER BLAKE BAMBURG pa
920 OLIVER RD
MONROE, LA 71201-5702
Phone number: 318-807-6267
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Mailing Address
CHRISTOPHER BLAKE BAMBURG pa
130 DESIARD ST STE 355
MONROE, LA 71201-7363
Phone number: 318-807-7875
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