Provider Demographics
NPI:1417972043
Name:BURKHOLDER, JOHN C (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:C
Last Name:BURKHOLDER
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14241 NORTHWEST BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-5545
Mailing Address - Country:US
Mailing Address - Phone:361-664-9675
Mailing Address - Fax:361-664-1100
Practice Address - Street 1:4040 FIVE POINTS RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-4538
Practice Address - Country:US
Practice Address - Phone:361-241-7399
Practice Address - Fax:361-241-7464
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1129120225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist