Individual
TARA MICHELLE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
333 LONGWOOD AVE # LO-367, BOSTON, MA 02115-5711
(617) 355-8859
Mailing address
636 PEARL ST, READING, MA 01867-1144
(603) 969-4099
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3819
MA
Other
Enumeration date
09/15/2009
Last updated
05/07/2015
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