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Individual
MARK ANDREW BOLOIS
Active
Individual
MARK ANDREW BOLOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.470099
OH
164W00000X
Licensed Practical Nurse
143671
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821411273
—
OH
Enumeration date
05/16/2017
Last updated
10/30/2019
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