Provider Demographics
NPI:1346966496
Name:BOSTIC, FRANK J
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:J
Last Name:BOSTIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 PADDLE CT
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-4804
Mailing Address - Country:US
Mailing Address - Phone:770-298-7015
Mailing Address - Fax:
Practice Address - Street 1:2836 HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1026
Practice Address - Country:US
Practice Address - Phone:770-876-2229
Practice Address - Fax:678-961-5705
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010884111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor