Individual
JATOYA BOSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4932 HACKETT DR, DAYTON, OH 45417-6237
(937) 718-3322
Mailing address
4932 HACKETT DR, DAYTON, OH 45417-6237
(937) 718-3322
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
OH
Other
Enumeration date
06/04/2014
Last updated
07/03/2014
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