Individual
MR. CHARLES H. BURNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.P.
Contact information
Practice address
1302 CERES DR, LAFAYETTE, CO 80026-1230
(352) 359-6159
Mailing address
1302 CERES DR, LAFAYETTE, CO 80026-1230
(352) 359-6159
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP1491
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO745
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/21/2007
Last updated
03/26/2015
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