Organization
BURKE PEDIATRIC THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIME PENLEY OTR/L (PRESIDENT/OWNER)
(828) 438-0856
Entity
Organization
Contact information
Practice address
2101 ANTIOCH ROAD, MORGANTON, NC 28655-7765
(828) 438-0856
(828) 438-0856
Mailing address
2101 ANTIOCH ROAD, MORGANTON, NC 28655-7655
(828) 438-0856
(828) 438-0856
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NC
225X00000X
Occupational Therapist
4727
NC
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
4727
NC
225XP0200X
Pediatric Occupational Therapist
Primary
4727
NC
235Z00000X
Speech-Language Pathologist
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7200360
—
NC
05
—
7302083
—
NC
Enumeration date
07/16/2010
Last updated
09/27/2011
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