Provider Demographics
NPI:1588635056
Name:BURTON, CAREY LEIGH (MSPT)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:LEIGH
Last Name:BURTON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30323 MARY LN
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-8111
Mailing Address - Country:US
Mailing Address - Phone:303-816-0599
Mailing Address - Fax:
Practice Address - Street 1:1250 BERGEN PKWY
Practice Address - Street 2:SUITE B115
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-9584
Practice Address - Country:US
Practice Address - Phone:303-674-7889
Practice Address - Fax:303-674-8117
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8808225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist