Individual
TAMORA S BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.A.S, LMT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
10295
CO
225700000X
Massage Therapist
Primary
14174661-4701
UT
Other
Enumeration date
01/10/2011
Last updated
09/18/2024
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