Individual
LAUREN BOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
370 N 120TH AVE STE 20, HOLLAND, MI 49424-2196
(616) 396-5855
(616) 396-5720
Mailing address
75 KNOLLWOOD PKWY, HOLLAND, MI 49423-9284
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601009427
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275579765
—
MI
Enumeration date
08/07/2019
Last updated
12/10/2019
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