Provider Demographics
NPI:1003459496
Name:BURTON, MARGARET ANNE (MA, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANNE
Last Name:BURTON
Suffix:
Gender:F
Credentials:MA, LAT, ATC
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:BURTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAT, ATC
Mailing Address - Street 1:240 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-5004
Mailing Address - Country:US
Mailing Address - Phone:931-224-8587
Mailing Address - Fax:
Practice Address - Street 1:501 STOCKTON STREET
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24142
Practice Address - Country:US
Practice Address - Phone:931-224-8587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer