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Individual

CLINT REX BURGENER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
20 E POPLAR ST STE 206, WALLA WALLA, WA 99362-3099
(509) 527-1156
(509) 522-4933
Mailing address
53495 E BALLOU RD, MILTON FREEWATER, OR 97862-7400
(701) 263-7094

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60237216
WA

Other

Enumeration date
08/31/2011
Last updated
08/31/2011
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