Individual
JACK BURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7041 20TH AVE, CENTERVILLE, MN 55038-9737
(612) 924-3807
Mailing address
3808 HEATHER DR, EAGAN, MN 55122-1623
(952) 652-1693
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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