Individual
MR. GERALD WAYNE BURRUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5301 W 950 N, CARTHAGE, IN 46115-9772
(765) 565-6903
Mailing address
5301 W 950 N, CARTHAGE, IN 46115-9772
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003537A
IN
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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