Individual
RUSSELL BOLTON HARMONY
Active
Individual
RUSSELL BOLTON HARMONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
774657
CA
208VP0014X
Interventional Pain Medicine Physician
Primary
NP-1275A
ID
363LF0000X
Family Nurse Practitioner
21853
CA
363LF0000X
Family Nurse Practitioner
NP-1275A
ID
Other
Enumeration date
02/19/2013
Last updated
09/10/2024
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