Individual
SHAWN TRACY BURTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
710 137TH ST NE, BRADENTON, FL 34212-2751
(417) 229-0543
Mailing address
710 137TH ST NE, BRADENTON, FL 34212-2751
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA21089
FL
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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