Individual
MARY BURDITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1004 HOLIDAY LN, FULTON, KY 42041-8458
(270) 472-1971
Mailing address
1004 HOLIDAY LN, FULTON, KY 42041-8458
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
132257
KY
Other
Enumeration date
11/17/2016
Last updated
11/17/2016
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