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Individual

HENRY M BOLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2730 S VAL VISTA DR STE 187, GILBERT, AZ 85295-1684
(480) 324-0300
(480) 324-0324
Mailing address
2730 S VAL VISTA DR STE 187, GILBERT, AZ 85295-1684
(480) 324-0300
(480) 324-0324

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6810
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6810
AZ LICENSE NUMBER
AZ
Enumeration date
10/03/2017
Last updated
04/21/2021
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