Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 012059 | OH |
NPI | 1417453457 |
---|---|
Provider Name | Dr. Dana Lee Burton |
First Address | North Canton, OH 44720-7624 |
Second Address | North Canton, OH 44720-7624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2018 |
Last Update Date | 30/03/2018 |