Individual
THOMAS JEFFERSON BOLDEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11024 LAKEPOINTE ST, DETROIT, MI 48224-1769
(313) 854-5940
Mailing address
200 LENOX ST, DETROIT, MI 48215-3006
(313) 854-5940
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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