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NPI Code Detail

MEDICARE: GRAYSON L BOSEL

MEDICARE: GRAYSON L BOSEL
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1851800403
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRAYSON L BOSEL
Provider Business Mailing Address
First Line : 4861 DUCK CREEK RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45227-1421
Country : US
Telephone Number : 513-832-2884
Fax Number :
Provider Business Practice Location Address
First Line : 4861 DUCK CREEK RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45227-1421
Country : US
Telephone Number : 513-832-2884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2017
Last Update Date : 11/30/2022

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Directions to “ GRAYSON L BOSEL ” Practice Location

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