Provider Demographics
NPI:1982259891
Name:RICHARD E BURRUS DC
Entity Type:Organization
Organization Name:RICHARD E BURRUS DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BURRUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-640-2300
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:GENESEE
Mailing Address - State:MI
Mailing Address - Zip Code:48437-0218
Mailing Address - Country:US
Mailing Address - Phone:640-230-0810
Mailing Address - Fax:840-640-2115
Practice Address - Street 1:7407 N GENESEE RD
Practice Address - Street 2:
Practice Address - City:GENESEE
Practice Address - State:MI
Practice Address - Zip Code:48437-7722
Practice Address - Country:US
Practice Address - Phone:810-640-2300
Practice Address - Fax:810-640-2115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty