Individual
KEVIN BURCH SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
6103 MAGNOLIA POINTE BLVD, DULUTH, GA 30096-9059
(386) 898-3942
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
0014190811
GA
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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