Individual
MRS. LISA ELAINE BURDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
702 MAGNOLIA ST, RAYMORE, MO 64083-9353
(816) 678-6584
Mailing address
702 MAGNOLIA ST, RAYMORE, MO 64083-9353
(816) 678-6584
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2012025586
MO
Other
Enumeration date
03/27/2013
Last updated
03/27/2013
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