Shannon Marie Burkland

Individual provider Active NPI Physical Therapy Assistant · Fouke, AR

NPI 1255082863 · NPPES record last updated Jan 14, 2022

Key facts

NPI
1255082863
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
Practice address
370 E Redcut
Fouke, AR 71837-8017
Phone
(870) 653-4165
NPI assigned
Jan 14, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Yes

Addresses

Primary practice location

370 E Redcut
Fouke, AR 71837-8017

Mailing address

13 Elmwood LN
Texarkana, TX 75501-8956
Phone (903) 278-5757

Other providers in Fouke, AR

All providers in Fouke, AR · Physical Therapy Assistant in Arkansas

Sources for this page

Verify at the official NPI Registry.