Individual
BETSY JO BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12499 UNIVERSITY AVE STE 210, CLIVE, IA 50325-8288
(515) 440-2676
(515) 440-2677
Mailing address
2425 WESTOWN PKWY STE 100, WEST DES MOINES, IA 50266-1425
(515) 267-1819
(515) 401-1313
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
002351
IA
363AS0400X
Surgical Physician Assistant
Primary
002351
IA
Other
Enumeration date
11/01/2012
Last updated
06/13/2024
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