Individual
JAMES RANDALL BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
1441 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1707
(563) 888-6275
(563) 884-4638
Mailing address
1441 W CENTRAL PARK AVE, DAVENPORT, IA 52804-1707
(563) 888-6275
(563) 884-4638
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00037
IA
Other
Enumeration date
02/09/2007
Last updated
06/20/2008
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