Individual
ELIZABETH BOLTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
111 N 20TH ST, PHILOMATH, OR 97370-9621
(541) 368-4313
(541) 929-4967
Mailing address
PO BOX 455, PHILOMATH, OR 97370-0455
(541) 368-4313
(541) 929-4967
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1475
OR
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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