Individual
EDYTHE BOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
508 GREGORY ST, SCOTTSBORO, AL 35768-4239
(256) 256-1774
(256) 259-0761
Mailing address
2003 MOODY RIDGE RD, SCOTTSBORO, AL 35768-2305
(256) 259-3091
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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