Individual
MEREDITH STORM BOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2701 N ROCKWELL AVE, BETHANY, OK 73008-5246
(405) 789-4150
Mailing address
2701 N ROCKWELL AVE, BETHANY, OK 73008-5246
(405) 789-4150
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2714
OK
Other
Enumeration date
12/26/2016
Last updated
07/11/2024
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