Individual
RICHARD WAYNE BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
257 W SAINT GEORGE AVE, GRANTSBURG, WI 54840
(715) 463-5353
(715) 463-2753
Mailing address
257 W SAINT GEORGE AVE, GRANTSBURG, WI 54840-7827
(715) 463-5353
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4333-23
WI
363A00000X
Physician Assistant
9113
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
449390700
—
MN
Enumeration date
03/26/2006
Last updated
06/19/2018
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