Individual
MRS. SUSAN N BOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
55 LAKE AVE NORTH, UMMHC, WORCESTER, MA 01655
(508) 856-3367
(508) 856-8020
Mailing address
269 WILLIAMS ST, UXBRIDGE, MA 01569-1130
(508) 856-3367
(508) 856-8020
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1304
MA
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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