Individual
SALLY A BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2345 MAIN ST, GLASTONBURY, CT 06033-2211
(800) 998-0880
Mailing address
2124 ABBOTT AVE, ANN ARBOR, MI 48103-3904
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004561
MI
Other
Enumeration date
02/22/2006
Last updated
08/14/2007
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