Individual
RANDY BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
139 LAKE HEAD RD, NORWOOD, NC 28128-7607
(336) 391-5874
Mailing address
139 LAKE HEAD RD, NORWOOD, NC 28128-7607
(336) 391-5874
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
216642
NC
163WP2201X
Ambulatory Care Registered Nurse
RN2275155
MA
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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