Provider Demographics
NPI:1104873397
Name:BURTON, AMY LYNNE (ATC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNNE
Last Name:BURTON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:LYNNE
Other - Last Name:SHIPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:1200 W RADIO LN
Mailing Address - Street 2:ATHLETIC TRAINING ROOM
Mailing Address - City:ARKANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67005-4001
Mailing Address - Country:US
Mailing Address - Phone:620-441-2010
Mailing Address - Fax:
Practice Address - Street 1:1200 W RADIO LN
Practice Address - Street 2:ATHLETIC TRAINING ROOM
Practice Address - City:ARKANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:67005-4001
Practice Address - Country:US
Practice Address - Phone:620-441-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer