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1538747027
ETHAN TYLAR BURKE
SYRACUSE, NY
NPI
1538747027
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-03-29
Last Update Date
2022-05-04
Business Address
ETHAN TYLAR BURKE DO
750 E ADAMS ST
SYRACUSE, NY 13210-1834
Phone number: 315-464-4259
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Mailing Address
ETHAN TYLAR BURKE DO
11375 CORTEZ BLVD
BROOKSVILLE, FL 34613-5409
Phone number: 719-651-8833
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