Individual
TYMON NAKIA BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1949 E CARVER DR, PHOENIX, AZ 85040-2454
(480) 577-2858
Mailing address
5326 W MCNEIL ST, LAVEEN, AZ 85339-9606
(480) 577-2858
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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