Individual
NICOLE BURGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, ATC
Contact information
Practice address
1213 N BELT HWY, SUITE H, SAINT JOSEPH, MO 64506-2411
(816) 279-7778
Mailing address
PO BOX 3497, STURTEVANT, WI 53177-0300
(877) 552-2996
(866) 245-8064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2016021895
MO
Other
Enumeration date
06/28/2016
Last updated
08/10/2016
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