Individual
MS. SHIRLEY ANN BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT,CR
Contact information
Practice address
1207 BLACK RIDGE RD SW, FLOYD, VA 24091-4007
(540) 745-5483
Mailing address
1207 BLACK RIDGE RD SW, 302 OXFORD ST., FLOYD, VA 24091-4007
(540) 745-5483
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0019000722
VA
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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