Individual
SAMANTHA BOLLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNIM
Contact information
Practice address
860654 S 3430 RD, CHANDLER, OK 74834-7078
(979) 248-9890
Mailing address
860654 S 3430 RD, CHANDLER, OK 74834-7078
(979) 248-9890
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
CNIM2768
TX
Other
Enumeration date
01/09/2014
Last updated
11/11/2016
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