Individual
BRANDON J BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 BALL AVE NE, GRAND RAPIDS, MI 49505-5904
(616) 456-6571
(616) 774-2044
Mailing address
1101 BALL AVE NE, GRAND RAPIDS, MI 49505-5904
(616) 456-6571
(616) 774-2044
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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