Provider Demographics
NPI:1083350169
Name:BURTON, JESSICA LEE (LPT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LEE
Last Name:BURTON
Suffix:
Gender:F
Credentials:LPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:ATLASBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15004-0297
Mailing Address - Country:US
Mailing Address - Phone:724-947-9999
Mailing Address - Fax:724-947-2291
Practice Address - Street 1:1569 SMITH TWP STATE RD
Practice Address - Street 2:
Practice Address - City:ATLASBURG
Practice Address - State:PA
Practice Address - Zip Code:15004-1209
Practice Address - Country:US
Practice Address - Phone:724-947-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist