Individual
JAY W BOSCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1480 W CENTER RD, STE 14, ESSEXVILLE, MI 48732-2143
(989) 892-5555
(989) 892-9525
Mailing address
1480 W CENTER RD, STE 14, ESSEXVILLE, MI 48732-2143
(989) 892-5555
(989) 892-9525
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002847
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94-4445853
—
MI
05
—
944445853
—
MI
Enumeration date
06/10/2005
Last updated
12/26/2008
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