Individual
MR. KERRY DEAN BRANUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
697 STATE ROUTE B, UNIT B, SAINT JAMES, MO 65559-1056
(636) 384-0540
Mailing address
697 STATE ROUTE B, UNIT B, SAINT JAMES, MO 65559-1056
(636) 384-0540
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2012022789
MO
Other
Enumeration date
07/13/2012
Last updated
06/18/2015
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