Provider Demographics
NPI:1336574631
Name:BURKHARDT, JOSHUA PAUL (PTA)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:PAUL
Last Name:BURKHARDT
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 HUNT ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-4426
Mailing Address - Country:US
Mailing Address - Phone:800-638-5503
Mailing Address - Fax:
Practice Address - Street 1:22 HUNT ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4426
Practice Address - Country:US
Practice Address - Phone:800-638-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1115225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant