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Individual

DR. KELLY M BOLESTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM.D.

Contact information

Practice address
1000 E MOUNTAIN BLVD # MC34-06, WILKES BARRE, PA 18711-0001
(570) 808-7706
(570) 808-6433
Mailing address
1000 E MOUNTAIN BLVD # MC34-06, WILKES BARRE, PA 18711-0001
(570) 808-7706
(570) 808-6433

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RP438081
PA
1835P1200X
Pharmacotherapy Pharmacist
RP438081
PA

Other

Enumeration date
01/25/2006
Last updated
01/10/2022
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