Individual
KATIE ELIZABETH BOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34 TULLYCROSS CT, TIMONIUM, MD 21093-1940
(443) 615-5242
Mailing address
771 CHESTNUT RD, EAST LANSING, MI 48824-3434
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002114
MI
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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