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NPI Code Detail

MEDICARE: KRISTIAN JEREMIE BURNHAM PT

MEDICARE:   KRISTIAN JEREMIE BURNHAM  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2024NH

General Provider Information

NPI Number : 1003888280
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIAN JEREMIE BURNHAM PT
Provider Business Mailing Address
First Line : 5 COLBY LN
Second Line :
City : BOW
State : NH
Zip : 03304-5103
Country : US
Telephone Number : 603-228-8252
Fax Number :
Provider Business Practice Location Address
First Line : 5 COLBY LN
Second Line :
City : BOW
State : NH
Zip : 03304-5103
Country : US
Telephone Number : 603-228-8252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 10/26/2007

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Directions to “ KRISTIAN JEREMIE BURNHAM PT” Practice Location

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