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1033495270
DERICK MICHAEL BOSLEY
SCRANTON, SC
NPI
1033495270
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
(Licence: SC 2348)
Enumeration Date
2011-11-02
Last Update Date
2011-11-02
Business Address
-- DERICK MICHAEL BOSLEY
1940 BOYD RD
SCRANTON, SC 29591-5835
Phone number: 843-389-9201
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Mailing Address
-- DERICK MICHAEL BOSLEY
HC 86 BOX 418C
FORT ASHBY, WV 26719-9719
Phone number: 301-697-2500
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