NPI 1033495270

Derick Michael Bosley

Practitioner Contractor Scranton, SC

Practice location

Address: 1940 Boyd Rd, Scranton, SC 29591-5835
Phone: (843) 389-9201
Mailing address: Hc 86 Box 418c, Fort Ashby, WV 26719-9719

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 2348 (SC)

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Registry record

NPI: 1033495270
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Nov 2011
Record last updated: 2 Nov 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.