Provider Demographics
NPI:1669648705
Name:BURNS, FRANK DAVID (COTA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:DAVID
Last Name:BURNS
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 FARRELL RD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-6505
Mailing Address - Country:US
Mailing Address - Phone:919-770-9602
Mailing Address - Fax:919-774-8523
Practice Address - Street 1:2702 FARRELL RD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-6505
Practice Address - Country:US
Practice Address - Phone:919-770-9602
Practice Address - Fax:919-774-8523
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5744224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5744OtherNCBOT LICENSE #
NC1075558OtherNBCOT CERTIFICATION #