Provider Demographics
NPI:1699064626
Name:BURICH, DANIEL R (DPT)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:R
Last Name:BURICH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2801 WARD BLVD STE 5C
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-1752
Mailing Address - Country:US
Mailing Address - Phone:252-281-2607
Mailing Address - Fax:252-281-0666
Practice Address - Street 1:3385 DEXTER CT STE 301
Practice Address - Street 2:5C
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27609
Practice Address - Country:US
Practice Address - Phone:563-344-6645
Practice Address - Fax:563-441-7796
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA13207225100000X
NCP13207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist