Individual
MR. LARRY ALDEN BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
208 NE BARRY RD, KANSAS CITY, MO 64155-2722
(816) 666-5511
Mailing address
4300 NE 102ND ST, KANSAS CITY, MO 64156-2914
(816) 666-5511
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2002001790
MO
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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