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NPI Code Detail

MEDICARE: DR. CRESENCIA JENE BURHANS OTR/L

MEDICARE: DR. CRESENCIA JENE BURHANS OTR/L
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
1225X00000XOccupational Therapist002343IA

General Provider Information

NPI Number : 1033546783
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRESENCIA JENE BURHANS OTR/L
Provider Business Mailing Address
First Line : 700 WAVERLY RD
Second Line :
City : DAVENPORT
State : IA
Zip : 52804-4317
Country : US
Telephone Number : 563-333-2808
Fax Number :
Provider Business Practice Location Address
First Line : 700 WAVERLY RD
Second Line :
City : DAVENPORT
State : IA
Zip : 52804-4317
Country : US
Telephone Number : 563-333-2808
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2013
Last Update Date : 09/26/2013

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