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Organization
BOLT SURGERY CENTER, LLC
Active
Organization
BOLT SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNA MORGAN (NURSE MANAGER)
(928) 486-6004
Entity
Organization
Contact information
Practice address
1124 S MAIN ST STE 102, CORONA, CA 92882-4449
(928) 486-6004
Mailing address
1124 S MAIN ST STE 102, CORONA, CA 92882-4449
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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