Provider Demographics
NPI:1255756813
Name:BURTON, VALERIE (MSPT)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18433-2009
Mailing Address - Country:US
Mailing Address - Phone:570-876-4716
Mailing Address - Fax:
Practice Address - Street 1:908 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:PA
Practice Address - Zip Code:18433-2009
Practice Address - Country:US
Practice Address - Phone:570-876-4716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist