Individual
MANDY BOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1300 N 12TH ST, SUITE 605, PHOENIX, AZ 85006-2848
(602) 839-4567
Mailing address
1300 N 12TH ST, SUITE 605, PHOENIX, AZ 85006-2848
(602) 839-4567
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2222222
AZ
Other
Enumeration date
04/04/2016
Last updated
04/04/2016
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