Individual
WYZLEE BUSSLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27849 AVONDALE ST, INKSTER, MI 48141-1717
(313) 646-0611
Mailing address
206 PONDEROSA TRL S, BELLEVILLE, MI 48111-5406
(313) 808-6329
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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