Individual
DENISE BOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
54 BRUEN AVE, IRVINGTON, NJ 07111-3513
(973) 444-8026
Mailing address
54 BRUEN AVE, IRVINGTON, NJ 07111-3513
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00244000
NJ
Other
Enumeration date
05/02/2014
Last updated
05/02/2014
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