Organization
BURDETTE FAMILY CHIROPRACTIC AND WELLNESS CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE WILSON BURDETTE III D.C. (PRESIDENT)
(304) 363-4006
Entity
Organization
Contact information
Practice address
307 CLEVELAND AVE., FAIRMONT, WV 26554
(304) 363-4006
(304) 363-4008
Mailing address
307 CLEVELAND AVE., FAIRMONT, WV 26554
(304) 363-4006
(304) 363-4008
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
800
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38100001785
—
WV
01
—
7028671
AETNA
WV
Enumeration date
01/12/2007
Last updated
08/22/2020
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