Individual
KIAN POURAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 BARNES JEW HOSP PLZ, SAINT LOUIS, MO 63110-1003
(314) 362-7388
Mailing address
4921 PARKVIEW PL # 6G, SAINT LOUIS, MO 63110-1032
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2024018873
MO
Other
Enumeration date
03/03/2023
Last updated
06/14/2024
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