Individual
JACQUELINE BURBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1020 N 27TH ST, BILLINGS, MT 59101-0760
(406) 238-5589
(406) 238-5266
Mailing address
4428 E CUB RIVER RD, PRESTON, ID 83263-5575
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
329940-2401
UT
225100000X
Physical Therapist
7959
AZ
225100000X
Physical Therapist
PT-2009
ID
225100000X
Physical Therapist
Primary
PTP-PT-LIC-2198
MT
Other
Enumeration date
07/31/2006
Last updated
08/17/2016
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