Provider Demographics
NPI:1902963846
Name:BURNS, ANDREW CD (DC, PC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CD
Last Name:BURNS
Suffix:
Gender:M
Credentials:DC, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 BROOKWOOD CTR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-3474
Mailing Address - Country:US
Mailing Address - Phone:636-717-0600
Mailing Address - Fax:636-717-0611
Practice Address - Street 1:910 BROOKWOOD CTR
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-3474
Practice Address - Country:US
Practice Address - Phone:636-717-0600
Practice Address - Fax:636-717-0611
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000146682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000014063Medicare ID - Type Unspecified