Individual
MR. RENARDO ANZELL BOWLES SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPRC, CPSS
Contact information
Practice address
1121 E MCNICHOLS RD, DETROIT, MI 48203-2857
(313) 365-3100
(313) 365-3101
Mailing address
5701 SAINT CLAIR ST, DETROIT, MI 48213-3348
(248) 818-6299
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/03/2022
Last updated
03/03/2022
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