Individual
MARY ILLONA BURFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
213 PARK ST, PALMER LAKE, CO 80133
(719) 651-7635
Mailing address
PO BOX 1324, PALMER LAKE, CO 80133-1324
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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