Individual
MARIA JOCELYN VISDA BOZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7601 PARKLANE RD, COLUMBIA, SC 29223-6122
(803) 741-9090
Mailing address
169 BIG BEAVER CREEK RD, ST MATTHEWS, SC 29135-7643
(803) 874-1830
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2669
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1472
—
SC
Enumeration date
09/14/2006
Last updated
07/08/2007
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