Individual
MRS. GRACE ELIZABETH BURNHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1637 RACE TRACK RD, SUITE 237, JACKSONVILLE, FL 32259-3239
(904) 287-8306
(904) 287-3413
Mailing address
1637 RACE TRACK RD, SUITE 237, JACKSONVILLE, FL 32259-3239
(904) 287-8306
(904) 287-3413
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA43029
FL
Other
Enumeration date
02/05/2008
Last updated
02/05/2008
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