Provider Demographics
NPI:1659671931
Name:KAISER, MICHELLE BURGESS (PT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:BURGESS
Last Name:KAISER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 SGT PRENTISS DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-4792
Mailing Address - Country:US
Mailing Address - Phone:601-442-9654
Mailing Address - Fax:601-442-9790
Practice Address - Street 1:46 SGT PRENTISS DR
Practice Address - Street 2:SUITE 103
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-4792
Practice Address - Country:US
Practice Address - Phone:601-442-9654
Practice Address - Fax:601-442-9790
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT 2022225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist