Provider Demographics
NPI:1518015742
Name:BURKE, KERRI ANNE (ATC)
Entity Type:Individual
Prefix:MS
First Name:KERRI
Middle Name:ANNE
Last Name:BURKE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24918 OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2465
Mailing Address - Country:US
Mailing Address - Phone:313-737-2013
Mailing Address - Fax:
Practice Address - Street 1:24918 OXFORD ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2465
Practice Address - Country:US
Practice Address - Phone:313-737-2013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
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