Provider Demographics
NPI:1780865410
Name:BURGER, JOSEPH A (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:BURGER
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 1:915 SIDNEY TER NW
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-3741
Mailing Address - Country:US
Mailing Address - Phone:941-625-5212
Mailing Address - Fax:
Practice Address - Street 1:915 SIDNEY TER NW
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-3741
Practice Address - Country:US
Practice Address - Phone:941-625-5212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-22
Last Update Date:2007-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 22914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist