Individual
MRS. CRISTY J BURGHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3000 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 321-7546
(269) 321-1705
Mailing address
3000 OLD CENTRE RD, PORTAGE, MI 49024-4883
(269) 321-7546
(269) 341-7883
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601006733
MI
Other
Enumeration date
09/12/2013
Last updated
10/09/2020
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