Individual
MOLLIE-JEAN BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSED, ATC
Contact information
Practice address
800 E CITY HALL AVE, SUITE 800, NORFOLK, VA 23510-2723
(401) 741-0845
Mailing address
1320 LONGDALE DR, APT 101, NORFOLK, VA 23513-4731
(401) 741-0845
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001695
VA
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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