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1154351302
LARRY DWAYNE BURNETT
JACKSON, TN
NPI
1154351302
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: TN 4703)
Enumeration Date
2006-07-04
Last Update Date
2009-07-17
Business Address
LARRY DWAYNE BURNETT PT
1725 S HIGHLAND AVE STE D
JACKSON, TN 38301-7767
Phone number: 731-421-8116
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Mailing Address
LARRY DWAYNE BURNETT PT
1804 HIGHWAY 45 BYP STE 604
JACKSON, TN 38305-4436
Phone number: 731-660-8759
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