Johnathan Christian Bodjack, BA

NPI #1528494762 in Portage, Michigan

Provider Information

NPI Number: 1528494762
Entity Type: Individual
Name: Johnathan Christian Bodjack, BA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Credential: BA
Enumeration Date: Sep 19, 2013
Last Updated: Sep 19, 2013

Practice Location

Address: 9616 PORTAGE RD
City: Portage
State: Michigan
ZIP Code: 49002-7257
Phone: (269) 250-8200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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