Individual
MRS. TONYA FAYE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
612 MOORE ST, FESTUS, MO 63028-1338
(636) 675-1948
Mailing address
612 MOORE ST, FESTUS, MO 63028-1338
(636) 675-1948
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004691
MO
Other
Enumeration date
08/27/2011
Last updated
08/27/2011
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