Provider Demographics
NPI:1396863601
Name:BURROWS, MISTY HARDIN (OTR)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:HARDIN
Last Name:BURROWS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 VISTA LOOP
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-7457
Mailing Address - Country:US
Mailing Address - Phone:717-630-0046
Mailing Address - Fax:
Practice Address - Street 1:85 VISTA LOOP
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-7457
Practice Address - Country:US
Practice Address - Phone:717-630-0046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC 009903225X00000X
MD5595225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist