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Individual

MRS. MANDY MARVIE BURKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
1278 CEDAR CENTER DR, TALLAHASSEE, FL 32301-4876
(850) 224-4114
Mailing address
1501 HASOSAW NENE, TALLAHASSEE, FL 32301-5829
(850) 566-4263

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA27080
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C8596
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/16/2007
Last updated
04/27/2011
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