Individual
MR. DAMON R BOSSCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, NASM-CPT
Contact information
Practice address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
Mailing address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501016568
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501016568
LICENSE
MI
Enumeration date
06/19/2014
Last updated
02/27/2020
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