Individual
EVAN BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1685 W 2200 S, SALT LAKE CITY, UT 84119-1456
(801) 887-5455
Mailing address
33 LOST CREEK LN, 403, MURRAY, UT 84107-7964
(248) 225-3729
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
10197781-2401
UT
Other
Enumeration date
03/31/2017
Last updated
03/31/2017
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