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1528449964
LEROY BURGESS
SOUTH BEND, IN
NPI
1528449964
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TH0100X Psychologist Health Service
(Licence: IN 99066271A)
Enumeration Date
2015-06-11
Last Update Date
2015-06-11
Business Address
DR. LEROY BURGESS PSYCHOLOGIST
300 S SAINT LOUIS BLVD STE 202
SOUTH BEND, IN 46617-3044
Phone number: 574-232-1405
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Mailing Address
DR. LEROY BURGESS PSYCHOLOGIST
300 S SAINT LOUIS BLVD STE 202
SOUTH BEND, IN 46617-3044
Phone number: 574-232-1405
Copy
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