Individual
LISA BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
114 RUSH ST, PETOSKEY, MI 49770-2920
(231) 347-5511
Mailing address
704 EMMET ST, PETOSKEY, MI 49770-2910
(231) 347-9880
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
05/20/2022
Last updated
05/20/2022
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