Healthcare Provider Details

I. General information

NPI: 1336310531
Provider Name (Legal Business Name): ALAN L.BURKE CHIROPRACTIC PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W EATON AVE
TRACY CA
95376-3422
US

IV. Provider business mailing address

550 W EATON AVE
TRACY CA
95376-3422
US

V. Phone/Fax

Practice location:
  • Phone: 209-836-2225
  • Fax: 209-836-2142
Mailing address:
  • Phone: 209-836-2225
  • Fax: 209-836-2142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. ALAN LEE BURKE
Title or Position: OWNER
Credential: D.C.
Phone: 209-836-2225