Individual
DEREK BODO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 UNIVERSITY PLZ, YOUNGSTOWN, OH 44555-0001
(330) 941-9000
Mailing address
60 N RACCOON RD APT 40, AUSTINTOWN, OH 44515-2709
(330) 207-1797
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/30/2018
Last updated
11/30/2018
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