Healthcare Provider Details

I. General information

NPI: 1699314047
Provider Name (Legal Business Name): MELISSA G BURZLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA G GREENSTEIN OTR/L

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 DUNDAS CIR STE B
GREENSBORO NC
27407-1638
US

IV. Provider business mailing address

5604 SAGE BRUSH TRL
GREENSBORO NC
27409-2709
US

V. Phone/Fax

Practice location:
  • Phone: 336-294-3338
  • Fax: 336-294-6696
Mailing address:
  • Phone: 206-354-7264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number12989
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: