Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 3360 | MA |
NPI | 1003188954 |
---|---|
Provider Name | Dr. Kimberly V Burke |
First Address | Oak Bluffs, MA 02557-1666 |
Second Address | Oak Bluffs, MA 02557 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2012 |
Last Update Date | 17/07/2013 |