Provider Demographics
NPI:1386672764
Name:BURTON, TOBEY T (MS, OTR L)
Entity Type:Individual
Prefix:MS
First Name:TOBEY
Middle Name:T
Last Name:BURTON
Suffix:
Gender:F
Credentials:MS, OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:982 EASTERN PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1566
Mailing Address - Country:US
Mailing Address - Phone:502-635-6397
Mailing Address - Fax:502-635-1147
Practice Address - Street 1:982 EASTERN PARKWAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241
Practice Address - Country:US
Practice Address - Phone:502-635-6397
Practice Address - Fax:502-635-1147
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R0013225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist