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General NPI Number Information
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NPI Number | 1265020457
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Entity Type | Organization
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Legal Business Name | BURNHAM CLINIC PLLC
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 1015 W FRONTAGE RD STE 104
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City | OWATONNA
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State | MN
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Zip | 55060-5511
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Country | US
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Telephone | 507-413-0962
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 W FRONTAGE RD STE 104
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City | OWATONNA
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State | MN
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Zip | 55060-5511
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA BURNHAM
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Credential | DC
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Telephone | 507-338-9683
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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 |
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License Number State |
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