Individual
MR. CHARLES ARTHUR BOLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPED
Contact information
Practice address
4546 MAPLECREST RD, FT WAYNE, IN 46835
(260) 492-1752
(260) 492-1752
Mailing address
4546 MAPLECREST RD, FT WAYNE, IN 46835
(260) 492-1752
(260) 492-1752
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1954
CPED
—
01
—
46966
PFA
—
Enumeration date
05/01/2008
Last updated
05/01/2008
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