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General NPI Number Information
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NPI Number | 1871743823
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Entity Type | Individual
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Provider Name | ALEXANDRA D BURNS OTR L
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Gender | Female
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 10/08/2008
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Provider Practice Location Address
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Address Line | 825 N MAIN ST
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City | PIEDMONT
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State | MO
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Zip | 63957-1222
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Country | US
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Telephone | 573-223-7426
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Fax | 573-223-2932
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Provider Business Mailing Address
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Address Line | 3188 LUTHER LN
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-2172
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Country | US
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Telephone | 573-686-3845
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Fax | 573-727-2460
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 005455
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License Number State | MO
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