Provider Demographics
NPI:1558467134
Name:BOSLER, CHERYL JONES (PTA)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:JONES
Last Name:BOSLER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 HIGHWAY 71
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-4994
Mailing Address - Country:US
Mailing Address - Phone:864-446-2013
Mailing Address - Fax:864-938-9240
Practice Address - Street 1:304 JACOBS HWY
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:SC
Practice Address - Zip Code:29325-7279
Practice Address - Country:US
Practice Address - Phone:864-833-2550
Practice Address - Fax:864-938-9240
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC767225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant