Individual
MARTI LEA BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2570 GOVERNMENT BLVD, MOBILE, AL 36606-1614
(251) 586-6481
(251) 586-6482
Mailing address
322 N INGLESIDE ST, FAIRHOPE, AL 36532-2924
(251) 689-6551
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12450
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12450
STATE LICENSE
AL
Enumeration date
06/18/2017
Last updated
06/18/2017
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