Provider Demographics
NPI:1710386966
Name:BOSKO FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:BOSKO FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOSKO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-643-0822
Mailing Address - Street 1:63 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-1511
Mailing Address - Country:US
Mailing Address - Phone:717-643-0822
Mailing Address - Fax:
Practice Address - Street 1:63 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225-1511
Practice Address - Country:US
Practice Address - Phone:717-643-0822
Practice Address - Fax:717-643-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007468L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty