Individual
MR. RONALD DEBOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1139 THOMAS ST SE, GRAND RAPIDS, MI 49506-2665
(616) 459-6817
(616) 459-1930
Mailing address
1427 BALL AVE NE, GRAND RAPIDS, MI 49505-5613
(616) 459-6817
(616) 459-1930
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/26/2012
Last updated
10/26/2012
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