Provider Demographics
NPI:1306678925
Name:BURCH, ERIN J
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:J
Last Name:BURCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 ROQUE MORAES DR APT 4
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2243
Mailing Address - Country:US
Mailing Address - Phone:201-787-7293
Mailing Address - Fax:201-787-7293
Practice Address - Street 1:619 E BLITHEDALE AVE STE B
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1482
Practice Address - Country:US
Practice Address - Phone:415-388-5223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2912842251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic