Individual
TOM BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1415 W US HIGHWAY 50, O FALLON, IL 62269-1618
(618) 624-4471
(618) 624-4496
Mailing address
1415 WEST US HIGHWAY 50, O'FALLON, IL 62269-3014
(618) 624-4471
(618) 624-4496
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
1359
IL
Other
Enumeration date
04/25/2007
Last updated
08/28/2013
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