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JON S BOS PSY.D.

Clinical Neuropsychologist

Grand Rapids, Michigan

Provider NPI: 1922123645

Provider Information:
 JON S BOS PSY.D.
Gender: M
Sole Proprietor


Practice Location:
640 3 MILE RD NW SUITE 101 GRAND RAPIDS, MI 49544 US
Tel: 616-785-8900  Fax: 616-785-8949

Business Mailing Address:
640 3 MILE RD NW SUITE 101 GRAND RAPIDS, MI 49544 US
Tel: 616-785-8900  Fax: 616-785-8949

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MI6301010098

Other Provider Identifiers:

IssuerNumberStateType
BCBS PROVIDER I.D.680D116880MI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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