Individual
KEONDRA V BURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
797 TEAGUE TRL APT 13207, LADY LAKE, FL 32159-3152
(352) 602-5541
Mailing address
797 TEAGUE TRL APT 13207, LADY LAKE, FL 32159-3152
(352) 602-5541
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/05/2017
Last updated
11/05/2017
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