Individual
MR. GARY LAMONT BURKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
2480 LLEWELLYN AVE, FORT MEADE, MD 20755-5800
(301) 677-8226
Mailing address
1934 HACKBERRY CT, ODENTON, MD 21113-2926
(410) 874-7301
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP31708
MD
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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