ETHAN TYLAR BURKE

SYRACUSE, NY
NPI1538747027
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-03-29
Last Update Date2022-05-04
Business Address
ETHAN TYLAR BURKE DO
750 E ADAMS ST
SYRACUSE, NY 13210-1834
Phone number: 315-464-4259
Mailing Address
ETHAN TYLAR BURKE DO
11375 CORTEZ BLVD
BROOKSVILLE, FL 34613-5409
Phone number: 719-651-8833