MEDICARE: PATRICK C 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	225200000X	Physical Therapy Assistant	PTA011124	OH

General Provider Information

NPI Number	:	1174021141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK C BURKE

Provider Business Mailing Address
First Line	:	3548 FENLEY RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-1346
Country	:	US
Telephone Number	:	513-254-3960
Fax Number	:

Provider Business Practice Location Address
First Line	:	3548 FENLEY RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-1346
Country	:	US
Telephone Number	:	513-254-3960
Fax Number	:

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

Provider Enumeration Date	:	01/24/2018
Last Update Date	:	01/24/2018

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Directions to “ PATRICK C BURKE ” Practice Location

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