Individual
MISS JUSTINE BARYE BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC, LAT
Contact information
Practice address
2301 SOUTH 291 HIGHWAY, INDEPENDENCE, MO 64057
(816) 373-9328
(816) 373-9207
Mailing address
316 DAINS ST, LIBERTY, MO 64068-2072
(816) 654-3748
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2018028574
MO
2255A2300X
Athletic Trainer
2015028356
MO
Other
Enumeration date
08/09/2018
Last updated
02/24/2025
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