Individual
JORDAN THOMAS BOZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-5000
Mailing address
7408 WESTBURY BLVD, WEST BLOOMFIELD, MI 48322-2816
(734) 624-7642
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704304246
MI
Other
Enumeration date
09/03/2020
Last updated
09/24/2020
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