Individual
MARTY G BURROUGHS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15275 TEXAS RD, SAINT ROBERT, MO 65584-3232
(573) 774-8364
Mailing address
15275 TEXAS RD, SAINT ROBERT, MO 65584-3232
(573) 774-8364
Taxonomy
Speciality
Code
Description
License number
State
344600000X
Taxi
Primary
S135329002
MO
Other
Enumeration date
11/04/2015
Last updated
06/20/2018
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