Individual
LAURA K BONEBRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9450 MANCHESTER RD, STE 206, SAINT LOUIS, MO 63119-1452
(314) 725-9300
(314) 725-4662
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(314) 725-9300
(314) 725-4662
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2012003217
MO
207V00000X
Obstetrics & Gynecology Physician
39532
IA
Other
Enumeration date
06/27/2007
Last updated
05/09/2012
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