Individual
MISS HEATHER S BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSR-PT
Contact information
Practice address
507 WATTS AVE, GREENVILLE, SC 29601-4357
(864) 313-1219
Mailing address
104 BRANDYBROOK LN, MAULDIN, SC 29662-2735
(843) 412-3589
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4704
SC
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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