Individual
CHARLES R BURGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
410 E 11TH AVE, BOWLING GREEN, KY 42101-2637
(270) 779-4271
Mailing address
8074 RUSSELLVILLE RD, BOWLING GREEN, KY 42101-7337
(270) 779-4271
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
KY-0662
KY
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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