Individual
MR. JONATHAN BURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3330 LACLEDE AVENUE, SAINT LOUIS UNIVERSITY - CHAIFETZ ARENA, SAINT LOUIS, MO 63103
(314) 977-3295
Mailing address
3330 LACLEDE AVENUE, CHAIFETZ ARENA, SAINT LOUIS, MO 63103
(314) 977-3295
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2007025048
MO
Other
Enumeration date
04/29/2014
Last updated
04/29/2014
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