Individual
KELLY BOLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5900 MEADOW CREEK DR, MILFORD, OH 45150-5641
(513) 248-1655
(513) 248-7340
Mailing address
640 SYCAMORE DR, INDEPENDENCE, KY 41051-8310
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
007894
OH
Other
Enumeration date
11/10/2013
Last updated
11/10/2013
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