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Individual

GAIL L BURD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
245 NORTH ST, BRISTOL, VA 24201-3274
(276) 669-4711
(276) 669-0834
Mailing address
121 EZEE ST, ELIZABETHTON, TN 37643-3848
(423) 543-8703

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2191
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000188
TN LICENSE NUMBER
TN
01
2191
VA LICENSE NUMBER
VA
Enumeration date
09/24/2006
Last updated
07/08/2007
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