Individual
MR. BERT BOVARD BOLDT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS PT
Contact information
Practice address
132 SALEM CT, TALLAHASSEE, FL 32301-2810
(850) 877-8177
(850) 942-0128
Mailing address
132 SALEM CT, TALLAHASSEE, FL 32301-2810
(850) 877-8177
(850) 942-0128
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0829
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000829
PHYSICAL THERAPY LICENSE
FL
Enumeration date
01/01/2007
Last updated
02/07/2008
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