Individual
BOBBY LEE BOCKRATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1852 FAIR OAKS DR, SIDNEY, OH 45365-1015
(937) 658-3143
Mailing address
1852 FAIR OAKS DR, SIDNEY, OH 45365-1015
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN167890
OH
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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