Provider Demographics
NPI:1568406072
Name:BOSCO, CHRISTOPHER FRANK (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:FRANK
Last Name:BOSCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 OLD MARLTON PIKE W
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2026
Mailing Address - Country:US
Mailing Address - Phone:856-596-3000
Mailing Address - Fax:
Practice Address - Street 1:1617 S STATE ST
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6435
Practice Address - Country:US
Practice Address - Phone:856-692-0334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00531400111N00000X
PADC007470L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor