Provider Demographics
NPI:1265910715
Name:BURLEW, JON CLAUDE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:CLAUDE
Last Name:BURLEW
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 EASTSIDE DR STE D
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8763
Mailing Address - Country:US
Mailing Address - Phone:502-867-0111
Mailing Address - Fax:502-867-0041
Practice Address - Street 1:101 EASTSIDE DR STE D
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8763
Practice Address - Country:US
Practice Address - Phone:502-867-0111
Practice Address - Fax:502-867-0041
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist