Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 003656 | OH |
Y | 222Z00000X | Podiatrist | 003656 | OH |
NPI | 1063724391 |
---|---|
Provider Name | Kristin Burton |
First Address | Gahanna, OH 43230-1797 |
Second Address | Gahanna, OH 43230-1797 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2010 |
Last Update Date | 19/07/2013 |