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Individual
DR. CORY J. BOSANKO
Active
Individual
DR. CORY J. BOSANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OD2541
TN
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
OD0000002541
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3943261
—
TN
05
—
3946606
—
TN
01
—
4109506
BCBST
TN
Enumeration date
08/02/2005
Last updated
01/22/2021
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