Individual
MR. LEEVI BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
216 COLLEGE BLVD., CARMI, IL 62821
(618) 382-4644
Mailing address
216 COLLEGE BLVD, CARMI, IL 62821-1548
(618) 382-4644
(618) 382-2906
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006315
IL
Other
Enumeration date
07/31/2013
Last updated
07/31/2013
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