Individual
SUSAN BOLOTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1810 S POWER RD, MESA, AZ 85206-4303
(480) 214-0045
(480) 924-5844
Mailing address
1810 S POWER RD, MESA, AZ 85206-4303
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085-005334
IL
363A00000X
Physician Assistant
Primary
8261
AZ
Other
Enumeration date
03/23/2015
Last updated
11/25/2022
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