Provider Demographics
NPI:1144463548
Name:BURKETT, ZACHARY JAMES (CHIROPRACTOR DC)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:JAMES
Last Name:BURKETT
Suffix:
Gender:M
Credentials:CHIROPRACTOR DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4749 HIGHWAY 17 BYP S
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-6682
Mailing Address - Country:US
Mailing Address - Phone:843-293-3887
Mailing Address - Fax:
Practice Address - Street 1:4749 HIGHWAY 17 BYP S
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-6682
Practice Address - Country:US
Practice Address - Phone:843-293-3887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC1967111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor