| Doctor Name: | DR. MICHAEL BURGOON |
| NPI Number: | 1043395825 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DC |
| License Number: | 0104001967 |
| Business Practice Address: | 2302 Colonial Ave Sw Suite A Roanoke, VA - 24015 |
| Business Phone Number: | 5403436636 |
| Business Fax Number: | 5403436670 |
| Mailing Address: | 2302 Colonial Ave Sw, Suite A ROANOKE |
| State: | VA |
| Postal Code: | 24015 |
| Phone Number: | 5403436636 |
| Fax Number: | 5403436670 |
| NPI Enumeration Date: | 10/27/2006 |
| NPI Last Update Date: | 07/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | 0104001967 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Chiropractic Providers |
| Taxonomy Classification: | Chiropractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |