Individual
JD BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13635 W LA REATA AVE, GOODYEAR, AZ 85395-2243
(623) 670-4930
Mailing address
13635 W LA REATA AVE, GOODYEAR, AZ 85395-2243
(623) 670-4930
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0193
AZ
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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