Individual
BURKE KEITH FULCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 SAW RD, CHINA GROVE, NC 28023-8541
(704) 223-0084
Mailing address
220 SAW RD, CHINA GROVE, NC 28023-8541
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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