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Bosco Cody Theodore, DO
Student in an Organized Health Care Education/Training Program in Salem, Virginia
NPI 1306422811

Bosco Cody Theodore is a Student in an Organized Health Care Education/Training Program based in Salem, VA. Bosco Cody Theodore practices in Salem, VA and has the professional credentials of DO. The NPI Number for Bosco Cody Theodore is 1306422811 and holds a License No. (Virginia).

The current practice location address for Bosco Cody Theodore is 1900 Electric Rd, Salem, VA and can be reached out via phone at 540-776-4000.

Location: 1900 Electric Rd, Salem, VA, 24153-7494
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306422811
Provider Name
Bosco Cody Theodore
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
1900 Electric Rd, Salem, VA, 24153-7494
Phone Number
540-776-4000
Fax Number
Provider Enumeration Date
03/23/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1900 Electric Rd
City
Salem
State
Virginia
Zip
24153-7494
Phone Number
540-776-4000
Fax Number
person
Provider Business Mailing Address Details
Address
1900 Electric Rd
City
Salem
State
Virginia
Zip
24153-7494
Phone Number
540-776-4000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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