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NPI Code Detail

MEDICARE: HEATHER JEAN BURRUM

MEDICARE:   HEATHER JEAN BURRUM
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 Therapist5501304001MI
2225100000XPhysical TherapistPT44072FL

General Provider Information

NPI Number : 1336000363
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER JEAN BURRUM
Provider Business Mailing Address
First Line : 812 HOLLY BUSH CT
Second Line :
City : HOLLY
State : MI
Zip : 48442-1328
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6150 N LOCKWOOD RIDGE RD
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2527
Country : US
Telephone Number : 248-766-5774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2025
Last Update Date : 12/12/2025

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Directions to “ HEATHER JEAN BURRUM ” Practice Location

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