Provider Demographics
NPI:1215552518
Name:BURFIELD, KARI RENEE (LMT, MMP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:RENEE
Last Name:BURFIELD
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2839 WYNHAVEN OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-1307
Mailing Address - Country:US
Mailing Address - Phone:678-577-9768
Mailing Address - Fax:
Practice Address - Street 1:2839 WYNHAVEN OAKS WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-1307
Practice Address - Country:US
Practice Address - Phone:678-577-9768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT011063225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA011063OtherGEORGIA SECRETARY OF STATE