Individual
KELSEY AYNE BOULIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
2900 S HANOVER ST, BALTIMORE, MD 21225-1232
(410) 802-1197
Mailing address
7628 LAUREL DR, PASADENA, MD 21122-1912
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
A0000588
MD
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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