Individual
MRS. JENNIFER DAWN BOSTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT/ATC, PTA
Contact information
Practice address
476 W US HIGHWAY 50 STE A, VERSAILLES, IN 47042-8340
(812) 689-1771
(812) 689-1778
Mailing address
476 W US HIGHWAY 50 STE A, VERSAILLES, IN 47042-8340
(812) 689-1771
(812) 689-1778
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000064A
IN
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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