Individual
JOHN S BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
720 S 11TH ST, NILES, MI 49120-3313
(269) 684-1418
(269) 684-1457
Mailing address
720 S 11TH ST, NILES, MI 49120-3313
(269) 686-1418
(269) 684-1457
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302029361
MI
Other
Enumeration date
12/27/2020
Last updated
12/27/2020
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