Individual
MR. LARRY HUGH BURKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1140 PERIMETER PARK DR, COOKEVILLE, TN 38501-0922
(931) 526-2345
(931) 528-1460
Mailing address
1140 PERIMETER PARK DR, COOKEVILLE, TN 38501-0922
(931) 526-2345
(931) 528-1460
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000000767
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0095650
BLUECROSS BLUESHIELD INDI
TN
Enumeration date
11/20/2006
Last updated
04/17/2020
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