Individual
MR. NATHANIEL LARUE BURNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
633 EMERSON RD, SUITE 20, CREVE COEUR, MO 63141-6739
(785) 845-3358
Mailing address
633 EMERSON RD, SUITE 20, CREVE COEUR, MO 63141-6739
(785) 845-3358
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2014028842
MO
2255A2300X
Athletic Trainer
416
NM
Other
Enumeration date
03/02/2012
Last updated
03/12/2015
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