MEDICARE: BOSKO FAMILY CHIROPRACTIC

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
1	111N00000X	Chiropractor	DC007468L	PA

General Provider Information

NPI Number	:	1710386966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSKO FAMILY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	63 S JEFFERSON ST
Second Line	:
City	:	GREENCASTLE
State	:	PA
Zip	:	17225-1511
Country	:	US
Telephone Number	:	717-643-0822
Fax Number	:

Provider Business Practice Location Address
First Line	:	63 S JEFFERSON ST
Second Line	:
City	:	GREENCASTLE
State	:	PA
Zip	:	17225-1511
Country	:	US
Telephone Number	:	717-643-0822
Fax Number	:	717-643-0953

Authorized Official
Title or Position	:	PROVIDER
Name	:	JASON K BOSKO
Credential	:	DC
Telephone Number	:	717-643-0822

Provider Enumeration Date	:	08/13/2014
Last Update Date	:	04/30/2021

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