Individual
BOSEDE O ADETUNJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15738 BOONRIDGE RD, HOUSTON, TX 77053
(614) 596-4626
Mailing address
15738 BOONRIDGE RD, HOUSTON, TX 77053-3732
(614) 596-4626
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
112143
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2422257
—
OH
Enumeration date
07/06/2006
Last updated
08/02/2018
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