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Individual

MR. ANTHONY BURRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.AC.

Contact information

Practice address
507 S FITNESS PL, STE 100, EAGLE, ID 83616-6552
(208) 938-1277
Mailing address
507 S FITNESS PL, STE 100, EAGLE, ID 83616-6552

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU-221
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010174226
REGENCE BLUE SHIELD OF IDAHO
ID
Enumeration date
09/01/2009
Last updated
02/29/2024
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