Provider Demographics
NPI:1366011777
Name:BURDIEK, EVAN (DPT)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:BURDIEK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 SW 17TH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-2514
Mailing Address - Country:US
Mailing Address - Phone:785-271-5533
Mailing Address - Fax:
Practice Address - Street 1:2117 SW 37TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2590
Practice Address - Country:US
Practice Address - Phone:785-266-5850
Practice Address - Fax:785-266-0021
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist