Individual
MELODY BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 RIDENOUR BLVD NW STE 300, KENNESAW, GA 30152-4402
(985) 722-7993
Mailing address
476 WILMER ST NE UNIT 1113, ATLANTA, GA 30308-2934
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
10618
GA
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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