Individual
JERROD BURGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1549 E LAS PALMARITAS DR, PHOENIX, AZ 85020-3854
(419) 612-6364
Mailing address
1549 E LAS PALMARITAS DR, PHOENIX, AZ 85020-3854
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
05/30/2018
Last updated
05/30/2018
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