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Individual

NICHOLAS TATE BURRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 825-5100
Mailing address
380 COUNTRY CLUB LN APT F, MADISONVILLE, KY 42431-3836
(270) 619-1609

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
03/29/2023
Last updated
03/29/2023
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