Individual
DAVID ALLEN BURRIS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1875 FANT DR, FORT OGLETHORPE, GA 30742-3307
(706) 861-3387
(706) 639-2054
Mailing address
84 SOUTHSHORE DR, FORT OGLETHORPE, GA 30742-4230
(706) 506-7792
(706) 944-4191
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1779
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00604513-GA
—
GA
Enumeration date
09/19/2018
Last updated
09/19/2018
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