Individual
MRS. CELESTE MARIE BURR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
7418693-4701
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7418693-4701
PROFESSIONAL LICENCE
UT
Enumeration date
11/02/2010
Last updated
11/02/2010
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