Healthcare Provider Details

I. General information

NPI: 1184606113
Provider Name (Legal Business Name): DANIEL CARL BURNS MSPT INC PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 POINT BROWN AVE NW
OCEAN SHORES WA
98569-9682
US

IV. Provider business mailing address

PO BOX 1833
OCEAN SHORES WA
98569-1833
US

V. Phone/Fax

Practice location:
  • Phone: 360-289-0251
  • Fax: 360-289-3226
Mailing address:
  • Phone: 360-289-0251
  • Fax: 360-289-3226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DANIEL CARL BURNS
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: MSPT
Phone: 360-289-0251