MALIA ALYS BURGESS

SAN DIEGO, CA
NPI1285998195
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CO  PTA-12149)
Additional Taxonomies225200000X Physical Therapy Assistant
(Licence: WA  P160043572)
Enumeration Date2012-06-26
Last Update Date2012-06-26
Business Address
Miss MALIA ALYS BURGESS PTA
12400 HIGH BLUFF DR
SAN DIEGO, CA 92130-3077
Phone number: 866-871-8519
Mailing Address
Miss MALIA ALYS BURGESS PTA
2125 CLEARVIEW AVE
FORT COLLINS, CO 80521-4209
Phone number: 360-201-8573