Individual
DAVID BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1411 STEELE AVE, CHANDLER, OK 74834-4219
(405) 882-7949
Mailing address
1411 STEELE AVE, CHANDLER, OK 74834-4219
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080835531
—
OK
Enumeration date
08/13/2009
Last updated
08/13/2009
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