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NPI Code Detail

MEDICARE: MICHELLE MARIE BURSKI

MEDICARE:   MICHELLE MARIE BURSKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2008027202MO

General Provider Information

NPI Number : 1356574008
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MARIE BURSKI
Provider Business Mailing Address
First Line : 418 N HIGHWAY 19
Second Line :
City : MONTGOMERY CITY
State : MO
Zip : 63361-5217
Country : US
Telephone Number : 573-564-2278
Fax Number : 573-564-6182
Provider Business Practice Location Address
First Line : 418 N HIGHWAY 19
Second Line :
City : MONTGOMERY CITY
State : MO
Zip : 63361-5217
Country : US
Telephone Number : 573-564-3710
Fax Number : 573-564-6182
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2009
Last Update Date : 08/28/2009

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Directions to “ MICHELLE MARIE BURSKI ” Practice Location

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