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General NPI Number Information
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NPI Number | 1619376761
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Entity Type | Individual
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Provider Name | AMBER BURSON ATC
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Gender | Female
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 705 W 13TH ST
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City | LEXINGTON
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State | NE
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Zip | 68850-1253
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Country | US
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Telephone | 308-631-2925
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Fax | 308-324-7224
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Provider Business Mailing Address
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Address Line | 705 W 13TH ST
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City | LEXINGTON
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State | NE
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Zip | 68850-1253
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Country | US
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Telephone | 308-631-2925
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Fax | 308-324-7224
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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 | 360
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License Number State | NE
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