Provider Demographics
NPI:1336745421
Name:BURFORD, DOMINIC (ATC)
Entity Type:Individual
Prefix:
First Name:DOMINIC
Middle Name:
Last Name:BURFORD
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 DANIA DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-3738
Mailing Address - Country:US
Mailing Address - Phone:240-291-4497
Mailing Address - Fax:
Practice Address - Street 1:601 F ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20004-1605
Practice Address - Country:US
Practice Address - Phone:814-331-7664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer