Individual
KELLY ANNE BURDETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
300 HOSPITAL ST, MOULTON, AL 35650-1268
(256) 974-1146
Mailing address
806 TIPTON DR, TUSCUMBIA, AL 35674-3120
(256) 381-8408
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
660
AL
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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