Individual
KIRK PFANNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 STODDARD RD, RICHMOND, MI 48062-2505
(810) 392-2167
Mailing address
13157 JULIUS AVE, WARREN, MI 48089-3254
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6801087168
MI
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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