Individual
TEVIN BURKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT,DPT
Contact information
Practice address
1021 W E ST, BELLEVILLE, IL 62220-1055
(618) 233-2095
Mailing address
809 FOXGROVE DR, FAIRVIEW HEIGHTS, IL 62208-2095
(901) 907-5384
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
070024075
IL
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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