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General NPI Number Information
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NPI Number | 1275746091
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Entity Type | Organization
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Legal Business Name | BOSWORTH URGENT CARE PC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1881 W GRAND RIVER AVE
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City | OKEMOS
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State | MI
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Zip | 48864-1840
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Country | US
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Telephone | 517-339-2100
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Fax | 517-339-4620
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Provider Business Mailing Address
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Address Line | 1881 W GRAND RIVER AVE
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City | OKEMOS
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State | MI
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Zip | 48864-1840
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Country | US
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Telephone | 517-339-2100
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Fax | 517-339-4620
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Authorized Official
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Title or Position | CREDENTIALING
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Name | KRISTINA ROWE
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Credential |
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Telephone | 517-485-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 5101014014
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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