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General NPI Number Information
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NPI Number | 1396054201
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Entity Type | Organization
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Legal Business Name | THADDEUS C. BOSMAN, D.C., INC.
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 8984 DARROW RD
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City | TWINSBURG
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State | OH
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Zip | 44087-2186
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Country | US
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Telephone | 330-425-2101
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Fax | 330-963-0478
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Provider Business Mailing Address
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Address Line | 8984 DARROW RD
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City | TWINSBURG
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State | OH
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Zip | 44087-2186
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Country | US
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Telephone | 330-425-2101
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Fax | 330-963-0478
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THADDEUS C. BOSMAN
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Credential | D.C.
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Telephone | 330-425-2101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1174
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License Number State | OH
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