Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 2305208400 | VA |
NPI | 1043644404 |
---|---|
Provider Name | Dr. Madeline C Bosek |
First Address | Charlottesville, VA 22901-8126 |
Second Address | Charlottesville, VA 22901-8126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2013 |
Last Update Date | 07/11/2013 |