Provider Demographics
NPI:1649362674
Name:BURNS, BETT ELAINE (LPTA)
Entity type:Individual
Prefix:MRS
First Name:BETT
Middle Name:ELAINE
Last Name:BURNS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-4303
Mailing Address - Country:US
Mailing Address - Phone:901-850-2088
Mailing Address - Fax:
Practice Address - Street 1:308 LAKE DR
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38068-9716
Practice Address - Country:US
Practice Address - Phone:901-465-9861
Practice Address - Fax:901-465-9897
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPTA669225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant