Individual
GEORGE EDWARD BURKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MEDICAL MASSAGE
Contact information
Practice address
21578 IREDELL TER, BROADLANDS, VA 20148-5033
(703) 858-9198
Mailing address
21578 IREDELL TER, BROADLANDS, VA 20148-5033
(703) 858-9198
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0019006812
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019006812
VA BOARD OF NURSING
VA
Enumeration date
06/18/2010
Last updated
06/18/2010
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