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NPI 1952560922

NPI 1952560922 : JENNIFER A BURDETT PT : CARROLLTON, TX

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General NPI Number Information
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    NPI Number           |    1952560922
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER A BURDETT PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/05/2008
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    Last Update Date     |    06/05/2008
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Provider Practice Location Address
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    Address Line         |    2329 PARKER RD 
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    City                 |    CARROLLTON
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    State                |    TX
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    Zip                  |    75010-4713
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    Country              |    US
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    Telephone            |    469-892-1228
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9905 CARMEL VALLEY DR 
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    City                 |    FRISCO
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    State                |    TX
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    Zip                  |    75035-8040
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    1141646
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    License Number State |    TX
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