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General NPI Number Information
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NPI Number | 1114248598
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Entity Type | Individual
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Provider Name | JOSEPH MICHAEL BURNHAM D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2010
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Last Update Date | 09/26/2011
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Provider Practice Location Address
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Address Line | 155 BLANDING BLVD SUITE 8
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City | ORANGE PARK
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State | FL
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Zip | 32073-2630
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Country | US
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Telephone | 904-803-2982
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Fax | 904-213-9806
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Provider Business Mailing Address
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Address Line | 155 BLANDING BLVD SUITE 8
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City | ORANGE PARK
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State | FL
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Zip | 32073-2630
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Country | US
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Telephone | 904-803-2982
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Fax | 904-213-9806
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 9801
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License Number State | FL
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