Individual
MR. TIMOTHY J BOLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2311 S KANSAS RD, NEWTON, KS 67114-9032
(316) 283-7187
(316) 283-7189
Mailing address
2311 S KANSAS RD, NEWTON, KS 67114-9032
(316) 283-7187
(316) 283-7189
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11-01593
KS
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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