Derick Michael Bosley

NPI #1033495270 in Scranton, South Carolina

Provider Information

NPI Number: 1033495270
Entity Type: Individual
Name: Derick Michael Bosley
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Contractor
Enumeration Date: Nov 2, 2011
Last Updated: Nov 2, 2011

Practice Location

Address: 1940 BOYD RD
City: Scranton
State: South Carolina
ZIP Code: 29591-5835
Phone: (843) 389-9201

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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