Individual
DR. JACK WESLEY BOLING JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
23441
MD
225100000X
Physical Therapist
25803
FL
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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