Individual
TASHIA SHADAI BOSTOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3109 CAMPUS DR, DAYTON, OH 45406-4122
(937) 278-0761
Mailing address
1839 SHAFTESBURY RD, DAYTON, OH 45406-3911
(937) 516-0858
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
402099220818
OH
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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