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Individual

BRIAN OURS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAT

Contact information

Practice address
3233 W ADDISON ST, CHICAGO, IL 60618-4328
(773) 478-0496
(773) 478-1251
Mailing address
4128 N CAMPBELL AVE, CHICAGO, IL 60618-2806

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
IL

Other

Enumeration date
06/14/2007
Last updated
07/08/2007
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