Individual
BRET DANIEL BOISCLAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2505 N LONG LAKE RD, FENTON, MI 48430-8840
(810) 471-0180
Mailing address
2505 N LONG LAKE RD, FENTON, MI 48430-8840
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502004370
MI
Other
Enumeration date
06/22/2026
Last updated
06/22/2026
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