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NPI Code Detail

MEDICARE: MRS. DENISE MARIE OSBORNE BSW, CBIS

MEDICARE: MRS. DENISE MARIE OSBORNE BSW, CBIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1932447174
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DENISE MARIE OSBORNE BSW, CBIS
Provider Business Mailing Address
First Line : 4222 BURTON ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-6121
Country : US
Telephone Number : 616-301-1347
Fax Number :
Provider Business Practice Location Address
First Line : 4222 BURTON ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-6121
Country : US
Telephone Number : 616-301-1347
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2013
Last Update Date : 01/23/2013

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