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Organization
BMAX PENNSYLVANIA LLC
Active
Organization
BMAX PENNSYLVANIA LLC
Active
Other names
Renewed Vitality
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY C BOLTON JR. MD (MD/OWNER)
(484) 516-2937
Entity
Organization
Contact information
Practice address
560 VAN REED RD, WYOMISSING, PA 19610-1799
(484) 516-2937
(484) 930-0229
Mailing address
560 VAN REED RD, WYOMISSING, PA 19610-1799
(484) 516-2937
(484) 930-0229
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
—
NULL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
—
—
Other
Enumeration date
08/08/2017
Last updated
07/21/2022
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