MEDICARE: MARY MICHELLE BURTON

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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1780553636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY MICHELLE BURTON

Provider Business Mailing Address
First Line	:	6309 RIVERBEND DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-2670
Country	:	US
Telephone Number	:	937-367-8822
Fax Number	:

Provider Business Practice Location Address
First Line	:	6309 RIVERBEND DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-2670
Country	:	US
Telephone Number	:	937-367-8822
Fax Number	:

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

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	10/30/2025

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Directions to “ MARY MICHELLE BURTON ” Practice Location

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