Individual
MS. RYAN ELAINE BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
75 EASTERN POINT RD, STATION A78, GROTON, CT 06340-4905
(860) 433-5193
Mailing address
75 EASTERN POINT RD, STATION A78, GROTON, CT 06340-4905
(860) 433-5193
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2528
CT
Other
Enumeration date
07/12/2011
Last updated
07/12/2011
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