Provider Demographics
NPI:1316228760
Name:BURFORD, KATHRYN JOANNE (ATC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JOANNE
Last Name:BURFORD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-1717
Mailing Address - Country:US
Mailing Address - Phone:712-274-5314
Mailing Address - Fax:712-274-5516
Practice Address - Street 1:1501 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-1717
Practice Address - Country:US
Practice Address - Phone:712-274-5314
Practice Address - Fax:712-274-5516
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA8202255A2300X
NE6312255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer