Individual
KEVIN MICHAEL BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2601 CRESTLINE CT, GLEN MILLS, PA 19342-8132
(610) 937-0688
Mailing address
2601 CRESTLINE CT, GLEN MILLS, PA 19342-8132
(610) 937-0688
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RTO000220
PA
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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