Individual
BONNIE JOYCE BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MTC
Contact information
Practice address
605 OLD BALLAS RD STE 128, SAINT LOUIS, MO 63141-7070
(314) 801-8776
(314) 801-8775
Mailing address
605 OLD BALLAS RD STE 128, SAINT LOUIS, MO 63141-7070
(314) 801-8776
(314) 801-8775
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070002879
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00150036
RR MEDICARE
IL
Enumeration date
07/10/2006
Last updated
02/23/2022
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