Lisa Burbage
NPI #1174021265 in Charleston, South Carolina
Provider Information
- NPI Number
- 1174021265
- Entity Type
- Individual
- Name
- Lisa Burbage
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Health Maintenance Organization
- Enumeration Date
- Jan 24, 2018
- Last Updated
- Jan 24, 2018
Practice Location
- Address
- 14 LOCKWOOD DR APT 12G
- City
- Charleston
- State
- South Carolina
- ZIP Code
- 29401-1138
- Phone
- (843) 442-8909
Specialties & Taxonomy Codes
| Specialty |
|---|
| Health Maintenance Organization |
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