Most Relevant Information
Provider Data
| NPI Number: | 1003262171 |
| Provider Name: | BERNICE BURROUGHS LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | M05618 |
Most Important Dates
| Enumeration Date: | 05/09/2016 |
| Last Updated: | 05/09/2016 |
Provider Practice Location
90 HOLIDAY DRIVE, SUITE D3
SOLOMONS
MD
20688
Practice Location Phone/Fax
| Phone: | 4104744841 |
| Fax: |
Provider Mailing Location
4650 HALLOWING POINT RD
PRINCE FREDERICK
MD
206783433
Provider Mailing Phone/Fax
| Phone: | 4104744841 |
| Fax: |