Provider Demographics
NPI:1578809547
Name:BURTON, BARRY C (PT)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:C
Last Name:BURTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1146
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82073-1146
Mailing Address - Country:US
Mailing Address - Phone:307-745-5434
Mailing Address - Fax:307-745-5484
Practice Address - Street 1:1575 N 4TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-2091
Practice Address - Country:US
Practice Address - Phone:307-745-5434
Practice Address - Fax:307-745-5484
Is Sole Proprietor?:No
Enumeration Date:2012-12-20
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist