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1578973657
MALISA M BURT
ROYAL OAK, MI
NPI
1578973657
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: MI 5601002694)
Enumeration Date
2014-04-29
Last Update Date
2014-04-29
Business Address
-- MALISA M BURT PA
127 FOREST AVE
ROYAL OAK, MI 48067-1843
Phone number: 248-229-7927
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Mailing Address
-- MALISA M BURT PA
127 FOREST AVE
ROYAL OAK, MI 48067-1843
Phone number: 248-229-7927
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