Individual
SHAWN LEE BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
827 W PRAIRIE AVE, HAYDEN, ID 83835-8459
(208) 660-9378
Mailing address
1022 N HARLEQUIN DR, POST FALLS, ID 83854-7573
(208) 660-9378
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-097
ID
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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