Provider Demographics
NPI:1821683491
Name:BURZLAFF, MADISON BURRIS (PT, DPT, EP-C)
Entity Type:Individual
Prefix:DR
First Name:MADISON
Middle Name:BURRIS
Last Name:BURZLAFF
Suffix:
Gender:F
Credentials:PT, DPT, EP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 NIXON RD APT 45
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-7000
Mailing Address - Country:US
Mailing Address - Phone:704-305-9255
Mailing Address - Fax:
Practice Address - Street 1:250 NIXON RD APT 45
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-7000
Practice Address - Country:US
Practice Address - Phone:704-305-9255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20161225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist