Provider Demographics
NPI:1891759700
Name:BURNIS, JAMES JOSEPH (DIPLAC, LAC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:JOSEPH
Last Name:BURNIS
Suffix:
Gender:M
Credentials:DIPLAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10869 E PLEASANT PL
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85218-4629
Mailing Address - Country:US
Mailing Address - Phone:480-671-5178
Mailing Address - Fax:480-288-9653
Practice Address - Street 1:10869 E PLEASANT PL
Practice Address - Street 2:
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85218-4629
Practice Address - Country:US
Practice Address - Phone:480-671-5178
Practice Address - Fax:480-288-9653
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0121171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist