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General NPI Number Information
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NPI Number | 1326934068
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Entity Type | Individual
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Provider Name | CASSIDY MARGARET BURDETTE BS, ATC
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Gender |
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 180 S FRONTAGE RD W STE 2700
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City | VAIL
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State | CO
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Zip | 81657-5038
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Country | US
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Telephone | 970-476-7220
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Fax | 877-546-1181
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Provider Business Mailing Address
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Address Line | 228 GRALAN RD
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City | CATONSVILLE
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State | MD
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Zip | 21228-4834
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Country | US
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Telephone | 410-615-9133
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT.0002841
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License Number State | CO
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