Individual
GINGERLY BOLALIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
6131 PARK RIDGE RD, LOVES PARK, IL 61111-4029
(815) 633-6810
Mailing address
351 BIENTERRA TRL APT 3, ROCKFORD, IL 61107-5861
(205) 516-5901
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070018258
IL
Other
Enumeration date
07/15/2011
Last updated
07/15/2011
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