Individual
DIANE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2763 NE ALDRICH AVE, SAME, BEND, OR 97701-9585
(541) 238-5216
Mailing address
2763 NE ALDRICH AVE, SAME, BEND, OR 97701-9585
(541) 238-5216
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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