MEDICARE: PAIGE BURKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305215918	VA

General Provider Information

NPI Number	:	1033892096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE BURKE

Provider Business Mailing Address
First Line	:	5695 KING CENTRE DR STE 102
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22315-5746
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5695 KING CENTRE DR STE 102
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22315-5746
Country	:	US
Telephone Number	:	703-924-2650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2023
Last Update Date	:	08/08/2023

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Directions to “ PAIGE BURKE ” Practice Location

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