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NPI Code Detail

MEDICARE: JEANETTE LYNN BOZIED PT

MEDICARE: JEANETTE LYNN BOZIED PT
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
1225100000XPhysical Therapist2305216691VA

General Provider Information

NPI Number : 1801327283
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANETTE LYNN BOZIED PT
Provider Business Mailing Address
First Line : 1514 W CARY ST
Second Line :
City : RICHMOND
State : VA
Zip : 23220-5306
Country : US
Telephone Number : 512-720-2402
Fax Number :
Provider Business Practice Location Address
First Line : 3600 SAUNDERS AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23227-4328
Country : US
Telephone Number : 804-358-1874
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2017
Last Update Date : 11/04/2024

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