Individual
IAN NICHOLAS BOSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1113 NORTH 8TH STREET, TERRE HAUTE, IN 47807
(812) 653-8183
Mailing address
1113 N 8TH ST, TERRE HAUTE, IN 47807-1517
(812) 653-8183
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2017
Last updated
07/21/2022
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