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Individual

MS. TAMMY BOSTELMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
802 W INDIANA ST, EDON, OH 43518-9627
(419) 272-3213
Mailing address
802 W INDIANA ST, EDON, OH 43518-9627
(419) 272-3213

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
DF1002221
OH

Other

Enumeration date
02/12/2014
Last updated
02/12/2014
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