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Individual
TY BURGESS
Active
Individual
TY BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2018028389
MO
225100000X
Physical Therapist
CP051573T
KS
225100000X
Physical Therapist
CP054373T
AL
Other
Enumeration date
02/08/2019
Last updated
09/24/2026
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