Provider Demographics
NPI:1447970231
Name:BURNS, ROBERT L III (RRT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:BURNS
Suffix:III
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 GROVER RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-9427
Mailing Address - Country:US
Mailing Address - Phone:231-830-5010
Mailing Address - Fax:
Practice Address - Street 1:493 GROVER RD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-9427
Practice Address - Country:US
Practice Address - Phone:231-830-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2102175692171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications