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NPI Code Detail

MEDICARE: MR. JASON LAWRENCE BURKE L.AC.

MEDICARE: MR. JASON LAWRENCE BURKE L.AC.
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
1171100000XAcupuncturistAC500192DC

General Provider Information

NPI Number : 1528196920
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASON LAWRENCE BURKE L.AC.
Provider Business Mailing Address
First Line : 7525 8TH ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20012-1813
Country : US
Telephone Number : 202-309-4958
Fax Number :
Provider Business Practice Location Address
First Line : 7525 8TH ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20012-1813
Country : US
Telephone Number : 202-309-4958
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 06/07/2016

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