Individual
MRS. COREY IONE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24788
OR
225700000X
Massage Therapist
MA60560728
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24788
LMT
OR
01
—
MA60560728
LMT
WA
Enumeration date
04/27/2015
Last updated
05/07/2020
Update your record
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