Individual
STACY BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
107 H ST, POPLAR, MT 59255-7817
(406) 768-2180
Mailing address
PO BOX 67, POPLAR, MT 59255-0067
(406) 768-2180
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
564629
NC
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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