Organization
NOTLOB ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES WADE BOLTON DC, APRN, FNP-C (PROVIDER)
(931) 432-5849
Entity
Organization
Contact information
Practice address
260 W 5TH ST, COOKEVILLE, TN 38501-1754
(931) 432-5849
(931) 400-0489
Mailing address
3624 LONG LANE RD, COOKEVILLE, TN 38506-8012
(214) 876-1248
(931) 432-4481
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/11/2018
Last updated
03/20/2019
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