Individual
CHADWICK BOBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
205 PALMER AVENUE, BELLEFONTAINE, OH 43311
(937) 592-4015
Mailing address
205 PALMER AVENUE, BELLEFONTAINE, OH 43311
(937) 592-4015
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.273386
OH
363LF0000X
Family Nurse Practitioner
Primary
COA.17410
OH
Other
Enumeration date
05/22/2015
Last updated
09/17/2015
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