Doctor Name: | ANDREW LEE BURLESON |
NPI Number: | 1831347285 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ARRT(R)(CT) |
License Number: | 3281 |
Business Practice Address: | 407 Washington Ave Crab Orchard, WV - 258279598 |
Business Phone Number: | 3042524785 |
Business Fax Number: | |
Mailing Address: | 407 Washington Ave, CRAB ORCHARD |
State: | WV |
Postal Code: | 258279598 |
Phone Number: | 3042524785 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2008 |
NPI Last Update Date: | 08/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2471C3402X |
License Number: | 3281 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WV |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | Radiography |
Taxonomy Definition: |