Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2301010208 | MI |
N | 111NS0005X | Chiropractic Sports Physician | 2301010208 | MI |
NPI | 1295138501 |
---|---|
Provider Name | Dr. Ronald Vincent Burr JR. |
First Address | Plymouth, MI 48170-3770 |
Second Address | Plymouth, MI 48170-5022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2014 |
Last Update Date | 30/09/2014 |