Organization
BURNHAM CHIROPRACTIC ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH BURNHAM D.C (OWNER)
(904) 310-4563
Entity
Organization
Contact information
Practice address
112 OLD JENNINGS RD, ORANGE PARK, FL 32065-7505
(904) 310-4563
Mailing address
112 OLD JENNINGS RD, ORANGE PARK, FL 32065-7505
(904) 310-4563
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH9881
—
111NI0013X
Independent Medical Examiner Chiropractor
CH9881
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004048000
—
FL
01
—
FL949A
MEDICARE PTAN
FL
Enumeration date
03/20/2013
Last updated
03/20/2013
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