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Individual

JOHN ALEXANDER BRUNDAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1311 N DIXIE HWY, BUILDING C, ELIZABETHTOWN, KY 42701-2621
(270) 769-1304
Mailing address
2903 S 3RD ST, APT 1, LOUISVILLE, KY 40208-1414
(937) 414-3652

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
04/07/2014
Last updated
04/07/2014
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