Individual
DR. MICHAEL LAWRENCE BOSQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., CCEP
Contact information
Practice address
836 WILLOW ST, OMRO, WI 54963-9373
(920) 685-3015
(920) 685-3017
Mailing address
836 WILLOW ST, OMRO, WI 54963-9373
(920) 685-3015
(920) 685-3017
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3157
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38885500
—
WI
Enumeration date
07/07/2005
Last updated
06/06/2013
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