Individual
DR. CONRAD BURBANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3715 GALLOWAY ST APT D112, BOZEMAN, MT 59718-5604
(773) 318-8866
Mailing address
3715 GALLOWAY ST APT D112, BOZEMAN, MT 59718-5604
(773) 318-8866
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-PSY-LIC-3564
MT
Other
Enumeration date
02/11/2022
Last updated
02/11/2022
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