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1093186207
JERROD RICHARD BURGESS
PORT HURON, MI
NPI
1093186207
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: MI 6802088745)
Enumeration Date
2015-10-14
Last Update Date
2017-04-28
Business Address
MR. JERROD RICHARD BURGESS BSW
3111 ELECTRIC AVE
PORT HURON, MI 48060-8127
Phone number: 810-985-8900
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Mailing Address
MR. JERROD RICHARD BURGESS BSW
3111 ELECTRIC AVE
PORT HURON, MI 48060-8127
Phone number: 810-985-8900
Copy
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