Individual
MRS. TINA MICHELLE BOLANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
225 MARKET ST, BROOKVILLE, OH 45309-1818
(937) 833-5711
Mailing address
225 MARKET ST, BROOKVILLE, OH 45309-1818
(937) 833-5711
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
9005
OH
Other
Enumeration date
10/07/2009
Last updated
10/07/2009
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