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Individual

TRENT BOLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3 WESTERN HILLS DR, PARKERSBURG, WV 26105-8122
(304) 420-1300
Mailing address
137 KAREN STREET, WASHINGTON, WV 26181
(304) 863-0651

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000676
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000676
WV
Enumeration date
02/23/2007
Last updated
07/08/2007
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