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Individual

SCOTT CHRISTOPHER BURGESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
130 GOFF MOUNTAIN RD, CROSS LANES, WV 25313-1419
(304) 388-7055
(304) 388-7508
Mailing address
415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
(304) 388-7782
(304) 388-7788

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2350
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810006515
WV
Enumeration date
07/24/2006
Last updated
11/15/2007
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