Provider Demographics
NPI:1245707223
Name:BURKE, COLLEEN ANN (DPT)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:ANN
Last Name:BURKE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 HUFFMAN MILL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8789
Mailing Address - Country:US
Mailing Address - Phone:336-584-7689
Mailing Address - Fax:336-584-8063
Practice Address - Street 1:1225 HUFFMAN MILL RD STE 201
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215
Practice Address - Country:US
Practice Address - Phone:336-584-7689
Practice Address - Fax:336-584-7689
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP17995225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist