Individual
MR. DANIEL J BURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
120 MEADOWCREST ST, SUITE 300, GRETNA, LA 70056-5255
(504) 392-7123
(504) 392-7823
Mailing address
722 CENTRAL AVE, RESERVE, LA 70084-5516
(504) 392-7123
(504) 392-7823
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.200267
LA
Other
Enumeration date
06/10/2009
Last updated
06/10/2009
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