Individual
MR. BRUCE BELFONTA MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC-M
Contact information
Practice address
17357 KLINGER ST, DETROIT, MI 48212-1035
(313) 893-3454
(313) 893-3454
Mailing address
17357 KLINGER ST, DETROIT, MI 48212-1035
(313) 893-3454
(313) 893-0713
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/15/2010
Last updated
06/15/2010
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