Individual
BLAINE ALLEN BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
7344 SUNCATCHER DR, HANAHAN, SC 29410
(580) 606-3484
Mailing address
7344 SUNCATCHER DR, HANAHAN, SC 29410
(580) 606-3484
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1148
SC
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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