Provider Demographics
NPI:1245338706
Name:BURKE, ELIZABETH A (PT, DPT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:BURKE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:HOLSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10520 N 78TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1216
Mailing Address - Country:US
Mailing Address - Phone:757-714-2221
Mailing Address - Fax:480-680-5362
Practice Address - Street 1:10520 N 78TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1216
Practice Address - Country:US
Practice Address - Phone:757-714-2221
Practice Address - Fax:480-680-5362
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204733225100000X
AZ11202225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7047852OtherAETNA
VA010319897Medicaid
VAP00367309OtherMEDICARE RAILROAD
VA192946OtherBCBS PHYSICAL THERAPY
VA011260T54Medicare PIN
VA192946OtherBCBS PHYSICAL THERAPY