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General NPI Number Information
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NPI Number | 1346380649
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Entity Type | Individual
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Provider Name | MARROW BURNETTE PT, MSPT, OCS, COMT
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Gender | Male
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 4745 SUTTON PARK CT SUITE 803
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City | JACKSONVILLE
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State | FL
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Zip | 32224-0250
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Country | US
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Telephone | 904-403-3880
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Fax | 904-337-1093
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Provider Business Mailing Address
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Address Line | 3141 BRACHENBURY LN
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City | JACKSONVILLE
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State | FL
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Zip | 32225-3716
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Country | US
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Telephone | 904-403-3880
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Fax | 904-337-1093
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 19660
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License Number State | FL
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