Individual
JACQUELINE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1521 DOWNTOWN WEST BLVD, KNOXVILLE, TN 37919-5407
(865) 545-4592
Mailing address
1521 DOWNTOWN WEST BLVD, KNOXVILLE, TN 37919-5407
(865) 545-4592
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3452
TN
Other
Enumeration date
05/21/2017
Last updated
06/11/2020
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