Organization
NORTHERN KENTUCKY CONSUMER DIRECTED OPTIONS PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY BOSLEY (FINANCE OFFICER)
(859) 283-1885
Entity
Organization
Contact information
Practice address
22 SPIRAL DR, FLORENCE, KY 41042-1300
(859) 283-1885
(859) 283-8178
Mailing address
22 SPIRAL DR, FLORENCE, KY 41042-1300
(859) 283-1885
(859) 283-8178
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43996073
—
KY
Enumeration date
03/12/2007
Last updated
04/22/2015
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