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General NPI Number Information
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NPI Number | 1043204282
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Entity Type | Individual
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Provider Name | MICHAEL SCOTT OSBORNE DC
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Gender | Male
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 02/17/2012
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Provider Practice Location Address
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Address Line | 1301 ODOVERO DR
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City | MARQUETTE
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State | MI
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Zip | 49855-5505
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Country | US
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Telephone | 906-228-2600
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Fax | 906-228-3878
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Provider Business Mailing Address
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Address Line | 1301 O'DOVERO DRIVE
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City | MARQUETTE
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State | MI
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Zip | 49855-3010
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Country | US
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Telephone | 906-228-2600
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Fax | 906-228-3878
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301007343
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License Number State | MI
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