Individual
MS. CORHONDA BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
119 S MAIN ST, SUITE 500, MEMPHIS, TN 38103-3647
(901) 312-5600
(901) 312-5605
Mailing address
119 S MAIN ST, SUITE 500, MEMPHIS, TN 38103-3647
(901) 312-5600
(901) 312-5605
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1790
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33738002
—
TN
Enumeration date
04/19/2011
Last updated
04/19/2011
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