Individual
DR. JEFFERY CLINTON COSGROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1905 LAKEVIEW DR, PORTAGE, MI 49002-6926
(269) 323-4605
Mailing address
1905 LAKEVIEW DR, PORTAGE, MI 49002-6926
(269) 323-4605
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
4901003809
MI
Other
Enumeration date
07/24/2006
Last updated
07/08/2007
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