Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2539 | OK |
NPI | 1003300203 |
---|---|
Provider Name | Robin Lyn Burchel |
First Address | Enid, OK 73701-5737 |
Second Address | Enid, OK 73701-5737 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2018 |
Last Update Date | 20/06/2018 |