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General NPI Number Information
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NPI Number | 1861130296
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Entity Type | Individual
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Provider Name | SEAN BURTON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 3100 N GLASSFORD HILL RD
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-2285
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Country | US
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Telephone | 928-445-3010
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Fax |
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Provider Business Mailing Address
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Address Line | 17450 E STATE ROUTE 169
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City | DEWEY
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State | AZ
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Zip | 86327-7308
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Country | US
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Telephone | 928-660-2186
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S025830
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License Number State | AZ
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