Individual
SCOTT BURTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5840 E DAKOTA RD, HEREFORD, AZ 85615-9723
(520) 803-0365
Mailing address
5840 E DAKOTA RD, HEREFORD, AZ 85615-9723
(520) 803-0365
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
11782
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000000
—
AS
Enumeration date
01/08/2009
Last updated
01/08/2009
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