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Brent Burnham
NPI 1407256050 · on the registry since 2014 · sole proprietor
Practice
- Address
- 273 Sawgrass Dr
Shreveport, LA 71106 - Phone
- (318) 464-2288
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 225100000X
225100000X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-09-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana