MEDICARE: DEBBIE BURGESS

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
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1942461413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBBIE BURGESS

Provider Business Mailing Address
First Line	:	6864 WYMAN WAY
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80030-5757
Country	:	US
Telephone Number	:	303-988-8319
Fax Number	:

Provider Business Practice Location Address
First Line	:	13510 W 8TH AVE
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80401-4608
Country	:	US
Telephone Number	:	303-887-1332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2008
Last Update Date	:	06/18/2008

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Directions to “ DEBBIE BURGESS ” Practice Location

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