Individual
ANTHONY BOSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1335 W MAIN ST STE B, LOWELL, MI 49331-1555
(616) 888-3184
Mailing address
PO BOX 30516, DEPT 5300, LANSING, MI 48909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501301744
STATE LICENSE
MI
Enumeration date
02/07/2022
Last updated
02/07/2022
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