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Individual

MR. TIMOTHY ISAAC BOSTICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CASE MANAGER PARAPRO

Contact information

Practice address
1505 S OSWEGO AVE, RUSSELLVILLE, AR 72802-2673
(479) 967-3370
(479) 967-2775
Mailing address
1505 S OSWEGO AVE, RUSSELLVILLE, AR 72802-2673
(479) 967-3370
(479) 967-2775

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
03/02/2007
Last updated
12/08/2008
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