Individual
JUSTIN BURKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11779 FREDERICK RD, ELLICOTT CITY, MD 21042-1031
(410) 794-6900
Mailing address
5901 GREENHILL AVE, BALTIMORE, MD 21206-2627
(410) 794-6900
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
51652
CA
225200000X
Physical Therapy Assistant
Primary
A5640
MD
225200000X
Physical Therapy Assistant
CP014946A
NC
225200000X
Physical Therapy Assistant
CP015771A
GA
225200000X
Physical Therapy Assistant
PT-2023-2071
NM
225200000X
Physical Therapy Assistant
PTA32173
FL
Other
Enumeration date
11/07/2022
Last updated
12/13/2023
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