Provider Demographics
NPI:1841532702
Name:BURCH, ROBERT SEAN (PTA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:SEAN
Last Name:BURCH
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 1:210 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:BONNER SPRINGS
Mailing Address - State:KS
Mailing Address - Zip Code:66012-1104
Mailing Address - Country:US
Mailing Address - Phone:785-727-5573
Mailing Address - Fax:
Practice Address - Street 1:210 CLARK ST
Practice Address - Street 2:
Practice Address - City:BONNER SPRINGS
Practice Address - State:KS
Practice Address - Zip Code:66012-1104
Practice Address - Country:US
Practice Address - Phone:785-727-5573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant