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Individual

DR. DENNIS LEE BURLISON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
11247 GROVE ST SE, MEHAMA, OR 97384
(503) 859-2181
(503) 859-3818
Mailing address
PO BOX 216, MEHAMA, OR 97384-0216
(503) 859-2181
(503) 859-3818

Taxonomy

Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
27-2457
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
075218
OR
Enumeration date
01/17/2007
Last updated
08/24/2009
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