Individual
BRIAN P BOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1115 2ND ST, FORT LUPTON, CO 80621-1745
(303) 857-4388
(303) 857-1179
Mailing address
203 S ROLLIE AVE, FORT LUPTON, CO 80621-1508
(303) 286-4560
(303) 286-4589
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1629
CO
Other
Enumeration date
12/20/2005
Last updated
07/13/2007
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