Organization
KINA BURRUSS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINA BURRUSS (DEVELOPMENTAL THERAPIST)
(501) 337-2153
Entity
Organization
Contact information
Practice address
1501 DOGWOOD TRL, MALVERN, AR 72104-4513
(501) 337-2153
Mailing address
1501 DOGWOOD TRL, MALVERN, AR 72104-4513
(501) 337-2153
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
222Q00000X
AR
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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