Individual
MR. ROY LUCAS BOSTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1425 FULTON RD, SUITE 315, SANTA ROSA, CA 95403-7618
(707) 545-7014
(707) 526-6739
Mailing address
6800 MINERS RAVINE RD, GRANITE BAY, CA 95746-9335
(916) 878-0741
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA7278
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HA7278
CALIFORNIA HEARING AID DISPENSER LICENSE HA7278
CA
Enumeration date
11/02/2016
Last updated
11/02/2016
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