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General NPI Number Information
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NPI Number | 1346638624
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Entity Type | Organization
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Legal Business Name | KAREN BURKE LMT
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Dates
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Enumeration Date | 01/08/2015
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Last Update Date | 01/08/2015
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Provider Practice Location Address
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Address Line | 5300 S ATLANTIC AVE UNIT 3402
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32169-4573
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Country | US
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Telephone | 386-689-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 5300 S ATLANTIC AVE UNIT 3402
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32169-4573
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Country | US
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Telephone | 386-689-1800
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | KAREN LOUSIE BURKE
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Credential | LMT
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Telephone | 386-689-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA34659
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License Number State | FL
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