Provider Demographics
NPI:1033382544
Name:BURTON, JOHN ROSEVEAR JR (MSPT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ROSEVEAR
Last Name:BURTON
Suffix:JR
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:19101 LIMESTONE COMMERCIAL DR STE 200
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-4511
Practice Address - Country:US
Practice Address - Phone:512-710-3235
Practice Address - Fax:512-710-3236
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ6353225100000X
TX1166150225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist