Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | OH1552 | OH |
NPI | 1356484893 |
---|---|
Provider Name | Dennis Thomas Burns |
First Address | Portsmouth, OH 45662-2816 |
Second Address | Portsmouth, OH 45662-3444 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0797884 | (05) | OH |
798046 | WORKERSCOMP EMLPOYER RISK (01) | OH |