Individual
GEORGE HENRY BASCOM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1685 BALDWIN AVE STE 100, PONTIAC, MI 48340-1242
(248) 706-3450
(248) 475-6403
Mailing address
1685 BALDWIN AVE STE 100, PONTIAC, MI 48340-1242
(248) 706-3450
(248) 475-6403
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
MI
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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