Healthcare Provider Details

I. General information

NPI: 1811733231
Provider Name (Legal Business Name): ANDREW BURKE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2024
Last Update Date: 07/04/2024
Certification Date: 07/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 CHATHAM BUSINESS DR
PITTSBORO NC
27312-5687
US

IV. Provider business mailing address

11 WHITEHALL DR
PITTSBORO NC
27312-1556
US

V. Phone/Fax

Practice location:
  • Phone: 919-542-6677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: