Individual
CONNER J BURCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 W BROADWAY ST STE 320, MISSOULA, MT 59802-4003
(406) 329-5615
(406) 329-5606
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(406) 329-5615
(406) 329-5606
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MED-PAC-LIC-115542
MT
363AS0400X
Surgical Physician Assistant
PA61100789
WA
Other
Enumeration date
06/20/2020
Last updated
02/21/2023
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