Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CO 001281 | CO |
NPI | 1184820391 |
---|---|
Provider Name | John Franklin Burgett |
First Address | Castle Rock, CO 80108-9066 |
Second Address | Denver, CO 80206-1514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 08/07/2007 |