Individual
BRIAN ROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6457 HICKORY LN, BURTON, MI 48509-9303
(248) 509-4774
Mailing address
6457 HICKORY LN, BURTON, MI 48509-9303
(248) 509-4774
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
01/17/2022
Last updated
01/17/2022
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