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Individual

REBECCA BURROUGHS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA., CMT

Contact information

Practice address
211 W BROAD ST, STE 101, RICHMOND, VA 23220-4216
(804) 288-3025
(804) 288-3029
Mailing address
5252 LYNGATE CT, STE 203, BURKE, VA 22015-1672
(703) 239-2300
(703) 239-2301

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604526
VA
225700000X
Massage Therapist
0019013673
VA

Other

Enumeration date
07/21/2016
Last updated
07/26/2016
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