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Organization
TRACI BOLIN, RDN, LD LLC
Active
Organization
TRACI BOLIN, RDN, LD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACI D BOLIN RDN, LD (REGISTERED DIETITIAN)
(316) 312-6388
Entity
Organization
Contact information
Practice address
14218 W BLUEGRASS CT, WICHITA, KS 67235-8065
(316) 312-6388
Mailing address
14218 W BLUEGRASS CT, WICHITA, KS 67235-8065
(316) 312-6388
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1966
KS
Other
Enumeration date
11/06/2014
Last updated
12/30/2014
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