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General NPI Number Information
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NPI Number | 1598486938
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Entity Type | Individual
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Provider Name | KIRA RYNEA BURGIN ATC
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Gender | Female
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Dates
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Enumeration Date | 09/05/2022
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 801 MEDICAL DR STE 400
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City | WENTZVILLE
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State | MO
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Zip | 63385-3824
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Country | US
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Telephone | 636-332-8455
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Fax | 636-332-8499
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Provider Business Mailing Address
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Address Line | 28826 CREEKVIEW DR
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City | WARRENTON
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State | MO
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Zip | 63383-2337
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Country | US
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Telephone | 660-988-5190
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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 | 2023028143
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License Number State | MO
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