Kathy J Bosch, DC

Individual provider Active NPI Chiropractor · Sonora, CA

NPI 1508942657 · NPPES record last updated Feb 21, 2017

Key facts

NPI
1508942657
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
DC012363 (CA)
Practice address
19515 Village Dr
Ste B
Sonora, CA 95370-9270
Phone
(209) 533-4330
Fax
(209) 532-5374
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DC012363CAMDChiropractor
DC12363CAMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC012363 CA Yes
Chiropractor 111N00000X DC12363 CA

Addresses

Primary practice location

19515 Village Dr
Ste B
Sonora, CA 95370-9270

Mailing address

19595 Village Dr
Ste B
Sonora, CA 95370
Phone (209) 533-4330

Other providers in Sonora, CA

All providers in Sonora, CA · Chiropractor in California

Sources for this page

Verify at the official NPI Registry.