Burgess Pediatrics, Inc.
401 Burgess Drive, Suite C,
Menlo Park, CA 94025-3408
For contract/billing questions contact
Leigh Phillips at email@example.com
or call (650) 305 2039
By choosing to use a credit card instead of bank debit via ACH, I accept a 3% credit card surcharge on each payment.
End billing when:30 days after patient provides written cancellation
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