Individual
MRS. THERESA BOLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
1151 TAYLOR STREET, 212-A, DETROIT HEALTH DEPT - COMMUNICABLE DISEASE DIVISION, DETROIT, MI 48202-1732
(313) 876-4138
(313) 876-0070
Mailing address
3969 SOMERSET AVE, DETROIT, MI 48224-3466
(313) 640-4074
(313) 876-0070
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
4704184140
MI
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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