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NPI 1851813604

NPI 1851813604 : VERONICA ANNMARIE BURKE : GRAFTON, MA

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General NPI Number Information
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    NPI Number           |    1851813604
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    Entity Type          |    Individual 
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    Provider Name        |    VERONICA ANNMARIE BURKE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/13/2017
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    Last Update Date     |    07/13/2017
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Provider Practice Location Address
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    Address Line         |    13 PULLARD RD UNIT 8 
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    City                 |    GRAFTON
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    State                |    MA
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    Zip                  |    01519-1127
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    Country              |    US
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    Telephone            |    774-275-4314
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    13 PULLARD RD UNIT 8 
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    City                 |    GRAFTON
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    State                |    MA
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    Zip                  |    01519-1127
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    Country              |    US
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    Telephone            |    
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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       |    
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    License Number State |    
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