Individual
MR. WILLIE EDWARD BURRELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13627 GRATIOT AVE, DETROIT, MI 48205-3433
(313) 521-0206
Mailing address
PO BOX 1450, WARREN, MI 48090-1450
(313) 485-7826
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
821198
MI
Other
Enumeration date
01/30/2009
Last updated
01/30/2009
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