Individual
B GEOFFREY BURNHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
324 FLANDERS RD, EAST LYME, CT 06333-1735
(860) 739-6953
(860) 739-2523
Mailing address
324 FLANDERS RD, EAST LYME, CT 06333-1735
(860) 739-6953
(860) 739-2523
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000080
CT
Other
Enumeration date
11/22/2005
Last updated
07/08/2007
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