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Individual

MR. JOHN BURNSIDE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
777 GLADES RD, BOCA RATON, FL 33431-6424
(561) 297-2044
Mailing address
1200 TALLWOOD AVE, 102, HOLLYWOOD, FL 33021-7973
(561) 297-3320

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 2282
FL

Other

Enumeration date
05/07/2015
Last updated
05/07/2015
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