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NPI Code Detail

MEDICARE: WILLIAM BURRUS

MEDICARE: WILLIAM BURRUS
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
1225200000XPhysical Therapy AssistantPTA0000004013TN

General Provider Information

NPI Number : 1750404026
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM BURRUS
Provider Business Mailing Address
First Line : 3232 NEW TOWNE RD
Second Line :
City : ANTIOCH
State : TN
Zip : 37013-1206
Country : US
Telephone Number : 615-367-2888
Fax Number :
Provider Business Practice Location Address
First Line : 3131 TOM AUSTIN HWY
Second Line :
City : SPRINGFIELD
State : TN
Zip : 37172-4801
Country : US
Telephone Number : 615-386-4900
Fax Number : 615-386-4999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 07/08/2007

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