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Individual

MISS ETHEL MAE BURTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3607 PENN DR, DURHAM, NC 27703-3656
(919) 598-5191
Mailing address
3607 PENN DR, DURHAM, NC 27703-3656
(919) 598-5191

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
32001509
NC
171W00000X
Contractor
Primary
32001509
NC

Other

Enumeration date
04/27/2016
Last updated
04/27/2016
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