Organization
PATRICK W BOZARTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK W BOZARTH (OWNER)
(906) 233-9762
Entity
Organization
Contact information
Practice address
227 N 9TH ST, ESCANABA, MI 49829-3815
(906) 233-9762
(906) 233-9763
Mailing address
227 N 9TH ST, ESCANABA, MI 49829-3815
(906) 233-9762
(906) 233-9763
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B11006
BCBSM
MI
Enumeration date
03/15/2007
Last updated
07/08/2008
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