Individual
MICHAEL BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
339 CONKLIN AVE, BINGHAMTON, NY 13903-2443
(607) 595-9022
Mailing address
339 CONKLIN AVE, BINGHAMTON, NY 13903-2443
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
111864
NY
Other
Enumeration date
09/08/2021
Last updated
07/11/2023
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