Individual
MS. MARY CARLA BOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.C., L.A.T.
Contact information
Practice address
474 OLD SAN ANTONIO HWY., BANDERA, TX 78003
(830) 796-5549
(830) 796-7934
Mailing address
PO BOX 1924, 693 WHISPERING WINDS RD., BANDERA, TX 78003-1924
(830) 796-6308
(830) 796-7934
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1434
TX
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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