Individual
IVORYNE MAUDE BOLLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
910 MIDWESTERN PKWY, WICHITA FALLS, TX 76302-2210
(940) 767-5500
Mailing address
910 MIDWESTERN PKWY, WICHITA FALLS, TX 76302-2210
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
204409
TX
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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