Individual
MR. BRUCE JAMES BURKHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
848 CAROLINA, MARYSVILLE, MI 48040-1240
(810) 364-5776
Mailing address
848 CAROLINA, MARYSVILLE, MI 48040-1240
(810) 364-5776
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
5502002849
MI
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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