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General NPI Number Information
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NPI Number | 1851513568
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Entity Type | Individual
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Provider Name | JEANETTE M BURNEY PT
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 55 PRATTS ISLAND ROAD
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City | SOUTHPORT MAINE
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State | ME
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Zip | 04576
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Country | US
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Telephone | 303-591-2739
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 539
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City | SOUTHPORT
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State | ME
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Zip | 04576-0539
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Country | US
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Telephone | 303-591-2739
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4157
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5858
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License Number State | ME
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