Individual
MR. JONATHAN LYNDELL BURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
20966 GRAND RIVER AVE, DETROIT, MI 48219-3937
(313) 255-4070
Mailing address
20966 GRAND RIVER AVE, DETROIT, MI 48219-3937
(313) 255-4070
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BUS2002-01531
MI
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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