Individual
MRS. DEE ANN BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, WCC
Contact information
Practice address
7465 MADISON AVE, INDIANAPOLIS, IN 46227-6564
(317) 788-3000
(317) 788-3005
Mailing address
3801 OLD BRUCEVILLE RD, VINCENNES, IN 47591-3889
(812) 886-4677
(812) 886-4678
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002021A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06002021A
PROFESSIONAL LICENSE
IN
01
—
6150719
WOUND CARE CERTIFIED
IN
Enumeration date
04/30/2010
Last updated
07/12/2012
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