Provider Demographics
NPI:1215158373
Name:BURDIGE, L JEFFREY (BS,DC)
Entity type:Individual
Prefix:DR
First Name:L
Middle Name:JEFFREY
Last Name:BURDIGE
Suffix:
Gender:M
Credentials:BS,DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14838 S. MILITARY TRAIL
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8153
Mailing Address - Country:US
Mailing Address - Phone:561-860-4532
Mailing Address - Fax:561-865-3371
Practice Address - Street 1:14838 S. MILITARY TRAIL
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8153
Practice Address - Country:US
Practice Address - Phone:561-860-4532
Practice Address - Fax:561-865-3371
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor