Provider Demographics
NPI:1356488563
Name:BURKHOUSE, DALE RICHARD (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:DALE
Middle Name:RICHARD
Last Name:BURKHOUSE
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47975 US HIGHWAY 41
Mailing Address - Street 2:PO BOX 274
Mailing Address - City:HOUGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:49931-9007
Mailing Address - Country:US
Mailing Address - Phone:906-281-0800
Mailing Address - Fax:906-483-1810
Practice Address - Street 1:600 MACINNES DR
Practice Address - Street 2:SUITE 201
Practice Address - City:HOUGHTON
Practice Address - State:MI
Practice Address - Zip Code:49931-1144
Practice Address - Country:US
Practice Address - Phone:906-483-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer