=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467493262
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JUDY L BURLINGAME DPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2006
-----------------------------------------------------
Last Update Date | 01/07/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6041 S SYRACUSE WAY SUITE 307
-----------------------------------------------------
City | GREENWOOD VILLAGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111-4771
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-482-0071
-----------------------------------------------------
Fax | 720-482-0081
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6041 S SYRACUSE WAY SUITE 307
-----------------------------------------------------
City | GREENWOOD VILLAGE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111-4771
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-482-0071
-----------------------------------------------------
Fax | 720-482-0081
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 5834
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------