Individual
JUSTIN BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1150 NORTHWEST DR, CHARLOTTESVILLE, VA 22901-2309
(434) 973-7933
Mailing address
8258 HAMILTON DR, GLOUCESTER, VA 23061-5297
(804) 695-6077
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204001566
VA
Other
Enumeration date
06/04/2025
Last updated
06/04/2025
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