Individual
JOHN I BOSWELL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1315 W COLLEGE AVE, SUITE 303, STATE COLLEGE, PA 16801-2776
(814) 861-3300
Mailing address
1315 W COLLEGE AVE, SUITE 303, STATE COLLEGE, PA 16801-2776
(814) 861-3300
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
035090-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010576160010
—
PA
Enumeration date
06/30/2005
Last updated
07/09/2007
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