Provider Demographics
NPI:1275240897
Name:BURNS, IRIS WOOD (OTD)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:WOOD
Last Name:BURNS
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:IRIS
Other - Middle Name:MARSHAE
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 PARKER AVE APT 3407
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-4469
Mailing Address - Country:US
Mailing Address - Phone:205-401-2590
Mailing Address - Fax:
Practice Address - Street 1:1 PARKER AVE APT 3407
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-4469
Practice Address - Country:US
Practice Address - Phone:205-401-2590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist