Individual
ANDI BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36301 LAKE RD, SHAWNEE, OK 74801-2321
(405) 765-2624
Mailing address
36301 LAKE RD, SHAWNEE, OK 74801-2321
(405) 765-2624
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3961
OK
Other
Enumeration date
01/09/2026
Last updated
01/09/2026
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