Individual
MISS SUSANNETTE BURROUGHS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. ED., BCMTB
Contact information
Practice address
922 1/2 ROSE AVE, PIEDMONT, CA 94611-4342
(650) 919-3054
Mailing address
17 GLEN EDEN AVE # 6, OAKLAND, CA 94611-4316
(510) 328-3679
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
71956
CA
Other
Enumeration date
10/29/2016
Last updated
09/16/2024
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