Provider Demographics
NPI:1104250174
Name:BURR, ROBERT ALLEN (MPT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALLEN
Last Name:BURR
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 N FULGHAM CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-4164
Mailing Address - Country:US
Mailing Address - Phone:559-901-2484
Mailing Address - Fax:559-627-0546
Practice Address - Street 1:703 N FULGHAM CT
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-4164
Practice Address - Country:US
Practice Address - Phone:559-901-2484
Practice Address - Fax:559-627-0546
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 21520225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist