Organization
DR BRUCE A FOWLER P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE ALLEN FOWLER PSY.D. (PRESIDENT)
(616) 450-4601
Entity
Organization
Contact information
Practice address
2090 CELEBRATION DR NE, SUITE 212, GRAND RAPIDS, MI 49525-9200
(616) 450-4601
(616) 608-0108
Mailing address
2090 CELEBRATION DR NE, SUITE 212, GRAND RAPIDS, MI 49525-9200
(616) 450-4601
(616) 608-0108
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301006137
MI
Other
Enumeration date
07/06/2007
Last updated
05/16/2024
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