Individual
EMPRESS BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 HUMBLE AVE STE 490, HATTIESBURG, MS 39401-6365
(866) 264-9450
Mailing address
3 HARTFORD CT, HATTIESBURG, MS 39402-8266
(228) 861-5600
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
06/25/2025
Last updated
06/25/2025
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