Individual
MRS. MARY ELIZABETH BOLGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2003 PIECK DR, FT MITCHELL, KY 41011-2627
(859) 653-1927
Mailing address
1 SPERTI DR, EDGEWOOD, KY 41017-9654
(859) 344-9322
(859) 344-9332
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
KY-R2141
KY
225X00000X
Occupational Therapist
Primary
R2141
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100335270
—
KY
Enumeration date
06/12/2007
Last updated
04/20/2016
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