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JERRELL S BOSTICK B.S.
NPI 1003163858
Massage Therapist in Daytona Beach, FL

Active since August 11, 2012
504 RAILWAY ST, DAYTONA BEACH, FL 32114(386) 679-8532 Get Directions Write a Review

NPPES record last updated: January 13, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerrell S Bostick B.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRELL S BOSTICK B.S. (NPI 1003163858) is an individual massage therapist in Daytona Beach, Florida, licensed in Texas (MT135450) and active in the NPI registry since August 2012.

NPPES Registry Identity

NPI1003163858
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameJERRELL S BOSTICKCredential: B.S.
Location Address504 RAILWAY STDaytona Beach, FL 32114-2654
Mailing Address504 Railway StDaytona Beach, FL 32114-2654 · (386) 679-8532
Phone(386) 679-8532
Sole ProprietorYes
Enumeration DateAugust 11, 2012
Last NPPES UpdateJanuary 13, 2024
NPPES CertifiedJanuary 13, 2024
✔ NPI 1003163858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
Licenses✔ Licensed in TX · MT135450✔ Licensed in FL · MA79474
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
504 RAILWAY ST, Daytona Beach, FL 32114
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerrell Bostick's NPI number?

The NPI number for Jerrell Bostick is 1003163858. It was assigned to this individual provider in the NPPES registry on August 11, 2012.

Where is Jerrell Bostick located?

Jerrell Bostick practices at 504 Railway St, Daytona Beach, FL 32114. The listed phone number is (386) 679-8532.

What is Jerrell Bostick's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Jerrell Bostick was last updated on January 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.