Individual
BRIAN LOWELL PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
404 N KEENE ST, COLUMBIA, MO 65201-6626
(573) 882-4438
(573) 884-9992
Mailing address
400 N KEENE ST, COLUMBIA, MO 65201-6626
(573) 882-4438
(573) 884-9992
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2018020641
MO
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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