Individual
SEAN BOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1852 SAVANNAH LN, YPSILANTI, MI 48198-3676
(631) 805-4959
Mailing address
1852 SAVANNAH LN, YPSILANTI, MI 48198-3676
(631) 805-4959
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703111465
MI
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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