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General NPI Number Information
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NPI Number | 1437444726
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Entity Type | Organization
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Legal Business Name | BURKE PHYSICAL THERAPY
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 2927 KERRY FOREST PKWY
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City | TALLAHASSEE
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State | FL
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Zip | 32309-7815
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Country | US
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Telephone | 601-329-1299
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 WESTGROVE
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City | TALLAHASSEE
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State | FL
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Zip | 32312-5015
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Country | US
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Telephone | 601-329-1299
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY/OWNER
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Name | EVAN MICHAEL BURKE
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Credential | DPT
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Telephone | 601-329-1299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT24543
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License Number State | FL
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