Individual
MARISSA RAE BURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
59 LIDDIE LOU, WINFIELD, MO 63389-3138
(636) 358-6479
Mailing address
59 LIDDIE LOU, WINFIELD, MO 63389-3138
(636) 358-6479
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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