Provider Demographics
NPI:1861878142
Name:BURKHARDT, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:BURKHARDT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CRESCENT CENTRE DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7269
Mailing Address - Country:US
Mailing Address - Phone:616-656-0379
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:780 BRIARCLIFF AVE
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-8756
Practice Address - Country:US
Practice Address - Phone:865-481-3163
Practice Address - Fax:865-481-3164
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CA296003225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist