Individual
CHRISTOPHER SULLIVAN BOURKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
6501 LOISDALE CT, SPRINGFIELD, VA 22150-1826
(703) 922-1000
Mailing address
6501 LOISDALE CT, SPRINGFIELD, VA 22150-1826
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E5421
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
SC006559
PA
Other
Enumeration date
04/05/2014
Last updated
05/31/2021
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