Provider Demographics
NPI:1841207115
Name:BURNS, RAYMOND C (PT)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:C
Last Name:BURNS
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 1:10500 BUCK
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:MI
Mailing Address - Zip Code:48623-9772
Mailing Address - Country:US
Mailing Address - Phone:989-573-0891
Mailing Address - Fax:888-972-5590
Practice Address - Street 1:4600 FASHION SQUARE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2676
Practice Address - Country:US
Practice Address - Phone:989-573-0891
Practice Address - Fax:888-972-5590
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2014-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501003959225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist