Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1061690501 | UT |
Y | 222Z00000X | Podiatrist | 1061690501 | UT |
NPI | 1023040276 |
---|---|
Provider Name | William H Burleigh |
First Address | West Jordan, UT 84084-4312 |
Second Address | West Valley City, UT 84119-3602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 03/02/2022 |