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Individual
KRISTIE L BOLL
Active
Individual
KRISTIE L BOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
004225
IA
225100000X
Physical Therapist
Primary
070-016288
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-016288
ILLINOIS PT LICENSE NO
IL
Enumeration date
03/17/2008
Last updated
04/11/2012
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