Provider Demographics
NPI:1023100187
Name:BURNS, TAMMY W (DC)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:W
Last Name:BURNS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7208
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25356-0208
Mailing Address - Country:US
Mailing Address - Phone:304-776-4959
Mailing Address - Fax:304-776-4965
Practice Address - Street 1:4988 WASHINGTON ST W
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-2050
Practice Address - Country:US
Practice Address - Phone:304-776-4959
Practice Address - Fax:304-776-4965
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor