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Individual

MR. DAVID BURNHAM I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3111 ELECTRIC AVE., PORT HURON, MI 48060
(810) 966-7863
(810) 985-7620
Mailing address
3111 ELECTRIC AVE., PORT HURON, MI 48060
(810) 966-7863
(810) 985-7620

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary

Other

Enumeration date
10/19/2009
Last updated
10/19/2009
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