Individual
THOMAS BURCHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2611 WAYNE AVE, DAYTON, OH 45420-1833
(937) 929-9085
Mailing address
2611 WAYNE AVE, DAYTON, OH 45420-1833
(937) 929-9085
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0037969
OH
Other
Enumeration date
01/12/2021
Last updated
01/23/2025
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