Individual
BRIAN THOMAS BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
949 CONNER ST, #220, NOBLESVILLE, IN 46060-2622
(317) 770-9223
(317) 770-9266
Mailing address
5966 CATLIN LN, NOBLESVILLE, IN 46062-6504
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05006803A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05006803A
PHYSICAL THERAPY LICENSE
IN
Enumeration date
10/11/2006
Last updated
07/08/2007
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