Marissa Rae Burch
Specialist/Technologist, Athletic Trainer in Winfield, MO. Individual provider (NPI-1).
NPI number1982162004
StatusActive
Last updated in NPPESMar 7, 2019
Details
- NPI
- 1982162004
- Entity type
- Individual (NPI-1)
- Name
- Marissa Rae Burch
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 7, 2019
- Last updated
- Mar 7, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
59 Liddie LouWinfield, MO 63389-3138
Phone 636-358-6479
Mailing address
59 Liddie LouWinfield, MO 63389-3138
Phone 636-358-6479
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