Individual
KIMBERLY ELAINE BURFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.B.O.C.
Contact information
Practice address
6201 FAMOUS AVE, SAINT LOUIS, MO 63139-3043
(314) 600-1779
Mailing address
6201 FAMOUS AVE, SAINT LOUIS, MO 63139-3043
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
015066
—
Other
Enumeration date
09/05/2011
Last updated
09/05/2011
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