Individual
MICHELLE RENEE BOLLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4260 FORT HENRY DR STE 18, KINGSPORT, TN 37663-2248
(423) 406-1200
Mailing address
4009 LAKE FOREST DR, KINGSPORT, TN 37663-3773
(423) 782-6160
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2024
Last updated
08/19/2024
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